Human Resources: Prescription Solutions' Program Helps Prevent Adverse Drug Reactions

Irvine, Calif.November 13, 2006 Interventions by pharmacists at
Prescription Solutions with physicians and patients have shown to resolve
seven out of 10 situations in which patients are taking either a combination
of medications or a specific medication that may increase the patient's risk
for a dangerous adverse drug reaction (ADR). The results were revealed
following completion of the specially designed clinical program implemented by
Prescription Solutions, a pharmacy benefit management company with
extensive experience in managing prescription medications, especially for
seniors.

"The excessive or unnecessary use of medications, otherwise known as
polypharmacy, is potentially dangerous because as people take more drugs,
their risk for complications increases," said Edmund Pezalla, M.D., vice
president and medical director for Prescription Solutions. "These complications
can lead to illness, injury and hospitalization and can even be fatal."

Polypharmacy, which can lead to an ADR, is more likely to occur in the
elderly, since they are more likely to be treated for multiple medical conditions
and under the care of multiple physicians. A recent analysis by Prescription
Solutions that examined seniors age 65 years or older over a three-month
period showed that one in six patients had at least one polypharmacy event.1
Sixty-one percent of older people seeing a physician are taking at least one
prescription medication,2 and most older Americans take an average of three
to five medications.3,4

Prescription Solutions' polypharmacy intervention program was implemented in
a large employee population and quickly identified approximately 3,000
members who were at risk for an ADR. The criteria for identifying members
experiencing polypharmacy included:

* Duplicate or overlapping therapy to treat the same disease or condition
* Concurrent use of interacting medications
* Use of a medication that interacts with a co-existing disease or condition
* Use of an inappropriate drug for the elderly
* Use of drug therapy to treat ADRs

By contacting physicians and patients to alert them to the situation as well
as providing educational information about polypharmacy, Prescription
Solutions' pharmacists were able to resolve incidents for about two-thirds of
the individuals who were identified as at risk for a polypharmacy incident. For
the other one-third of polypharmacy cases, neither the physician nor patient
responded.

An analysis of the program's results revealed that 62 percent of identified
polypharmacy cases were categorized as older adults using drugs not
recommended for the elderly due to the increased potential for ADRs. Thirty
percent of polypharmacy cases represented patients who had an increased
risk for an ADR because they were using a medication that interacted
negatively with one or more of their clinical conditions. For example, a patient
with asthma and high blood pressure is prescribed a beta-blocker to reduce
blood pressure. However, the beta-blocker also prevents widening of the
airways in the lungs, which could worsen the asthma (having a negative
effect). Fifteen percent were receiving medications with a known potential
for interacting with other medications they were also taking. An example of
this drug-drug interaction would be a patient with a lipid disorder (i.e., a
disorder characterized by excessive fatty substances in the blood) being
prescribed both a 'statin' medication and a 'fibrate' medication. Both drugs,
when used together, increase the risk for kidney and multiple organ failure.

Medication misuse costs the health care system more than $177 billion and
results in more than 200,000 deaths annually,5 as reported in the Journal of
the American Pharmaceutical Association. The Veterans Affairs medical
system found that the potential for an ADR among more than 40,000
individuals studied was 6 percent when two drugs were taken, 50 percent
when five drugs were taken and nearly 100 percent when eight or more drugs
were taken.6

"By evaluating the patient's entire prescription medication regimen and
notifying physicians and patients about potential problems by telephone or
mail, or by alerting the pharmacist at the community or mail-service pharmacy
in real-time when a prescription is being filled, we've demonstrated that we
can work with physicians and patients to avoid therapies that could be
harmful," noted Pezalla. "As a result, physicians have more complete
information on their patients, patient safety is improved, and plan sponsors
know that their health care dollars are being used cost-effectively and
efficiently to promote optimal health for their members and employees."

For more information about Prescription Solutions' programs, call (888) 398-
5189 or visit www.rxsolutions.com.

About Prescription Solutions

Prescription Solutions is an innovative pharmacy benefit management
company managing the prescription drug benefit of commercial, Medicare and
governmental health plans, as well as those of employers and unions.
Prescription Solutions serves members through state-of-the-art mail service
pharmacy locations in Carlsbad, California and Overland Park, Kansas, as well
as through a national network of 60,000 community pharmacies. Online
information can be found at www.rxsolutions.com.