Patent Publication Number: US-2009228302-A1

Title: System and method of prescribing alternative medications

Description:
PRIORITY 
     This application claims priority to U.S. Provisional Patent Appl. No. 61/068,313, filed Mar. 6, 2008, the contents of which are hereby incorporated by reference in its entirety. 
    
    
     BACKGROUND 
     1. Field 
     A system and method is provided to allow a physician to consider alternative medications while he is electronically prescribing medications to a patient, and to also allow the physician to be aware of and provide free medications and/or rebates to the patient. 
     2. Description of the Related Art 
     Over 3.2 billion prescriptions are written by physicians each year in the United States. The writing of prescriptions is now being modernized to fit into the modern computer society. A system of electronically prescribing medications to patients has been developed by a number of companies including a consortium under the NEPSI heading (National EPrescribing Patient Safety Initiative; see Http://www.nationalerx.com/sponsors.htm). 
     Another company providing computer software for electronic prescriptions is RxNT located in Annapolis, Md. The e-prescription initiative means that a physician or authorized party (nurse practitioner, etc.) can use an electronic device including a cell phone, pda, laptop, tablet or desktop computer, etc. to perform the following functions. 
     1. Review a patient&#39;s information including patient history. 2. Select a suitable medication for the patient and pick dosage and frequency (Or Alternatively let the eprescribing system suggest a medication). 3. Check the medication for allergies and drug interactions, etc. with a Drug Utilization Review (DUR). 4. Send the prescription to the patient&#39;s pharmacy and/or health plan provider. 5. Provide the patient with a copy of the prescription. 6. Update the physicians or practice&#39;s records with information on the prescription. 
     As the costs of prescription medicine continues to increase, a trend in the medical industry that has also increased is giving away free medication samples to physicians to give to the patients to use. A recent study which appears in the American Journal of Public Health estimates that one in ten Americans received one or more free samples in 2003. The free samples allow the patients to test the medications and also lowers the patients&#39; costs in using the medication. 
     The current system for dispensing the free medication is for a drug representative or drug company to either deliver or send the free samples to a qualified physician or qualified practice and for the physician or another authorized person (e.g. nurse practitioner) to give out the samples. 
     Another alternative in the system allows the patient to request a free sample directly from the drug manufacturer providing he/she sends the drug manufacturer an authorized prescription from the physician. Examples of medication samples include NasaCort, Nasonex and Viagra. Examples of drug manufacturers providing samples directly to the patients include the consumer oriented campaign that AstraZeneca Pharmaceuticals ran for the drug Crestor. 
     A need exists to allow the physician to direct free medical samples/rebates or alternative medications during the electronic prescribing (i.e., e-prescribing) process. Currently, there is no system or method for a physician to check to see if a free medication sample would be available for the patient or, alternatively, a rebate on a medication while he is e-prescribing a medication for a patient. This deficiency results in higher cost, and less information, for the patient. Further, there also exists a need for a physician to be able to choose between competing medications during the electronic prescribing process. Currently electronic prescribing systems suggest alternative medications to the physician, but this suggestion is based on compilations of medications in a medication database and not direct input or information from a medication manufacturer. 
     By example, if a physician is currently e-prescribing NasaCort to a patient, the electronic database may suggest an alternative medication such as Nasonex. However, this suggestion is without input from the Nasonex manufacturer who if they had input would be able to offer the physician and the patient free samples of the medication, rebates on the medication, or other up to date and pertinent information on the medication. Further, allowing the medication manufacturers direct input in the electronic prescribing process will allow the medication manufacturers to offer compensation to the organizers of the e-prescibing programs. 
     SUMMARY 
     A system and method of recommending alternative medications to a physician within the electronic prescribing process and providing free medication (samples), product information, or rebates to the patient is provided. The system and method provide for tagging an electronic prescription database so that one listed medication links to another alternative medication. Once the medication has been tagged, the system and method enables the displaying of the alternative medication information on a physician (users) data display terminal, e.g., a desktop computer or a portable device, after a medication is selected by the physician. 
     The alternative medication information includes information on providing the patient free user samples. The system and method provides for having the physician electronically elect to receive these alternative medication samples directly. Alternatively, the system and method allows the patient to receive the medication samples directly by having the physician electronically direct the samples from the manufacturer to the patient. 
     Furthermore, the alternative medication information includes information on patient rebates for the alternative medication. The system and method provides for sending these rebate offers electronically during the e-prescribing process to the physician, sending these rebate offers electronically during the e-prescribing process to the patient or printing out these rebate offers at the physician&#39;s office. 
     The system and method provides other alternative medication information on the selected medication, e.g., possible side effects, wherein the system and method allows the physician to print out information on the alternative medication or e-mail the patient information on the alternative medication. 
     The system and method of the present disclosure further enables a medication manufacturer access to the medication listings on the electronic prescription database so that they can tag these medications with information that would allow the physician to see alternative medications that the medication manufacturer is suggesting. 
     In one embodiment, the medication manufacturer is charged in an e-commerce transaction a fee or fees for tagging these medications with information that would allow the physician to see alternative medications that the medication manufacturer is suggesting. 
     In another embodiment, the medication manufacturer is charged in an e-commerce transaction a fee or fees for tagging these medications with information that would allow the physician to see alternative medications that are available for free to the patient or physician. 
     In a further embodiment, the medication manufacturer is charged in an e-commerce transaction a fee or fees for tagging these medications with information that would allow the physician to see alternative medications that are available for patient rebates. 
     In yet another embodiment, the medication manufacturer is provided with a control panel that will remotely access a database of medications so that the manufacturer can tag these medications so that when accessed they link to the medications/information/offers that the manufacturer is providing. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other aspects, features, and advantages of the disclosure will become more apparent in the light of the following detailed description when taken in conjunction with the accompanying drawings in which: 
         FIG. 1  is an overall flow diagram of a system and method for prescribing alternative medications in accordance with an embodiment of the present disclosure; and 
         FIG. 2  is a flow chart illustrating a method for prescribing alternative medications in accordance with an embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     Preferred embodiments of the disclosure will be described hereinbelow with reference to the accompanying drawings. In the following description, well-know functions or constructions are not described in detail to avoid obscuring the disclosure. 
     Embodiments of the present disclosure overcome the shortcomings of existing practices and provides a system and method for a physician to recommend alternative medications using an electronic prescribing process which provides free medications, product information and possible rebates to the patient. 
     Referring to  FIG. 1 , an overall flow diagram of a system and method for prescribing alternative medications is illustrated. Generally, the system  100  includes a terminal  102  for accessing server  106  by a user, e.g., a physician, over communications network  109 , e.g., the Internet, LAN, WAN, or other suitable network. The prescribing server  106  is configured for prescribing medications for a particular patient to a user of the system for example a physician. The prescribing server  106  is coupled to a first patient record database  108  and a second e-prescribing database  110 . The patient record database  108  includes a plurality of records, each record includes data for an individual patient, e.g., medical history, allergies to certain medicines, etc. The e-prescribing database  110  includes a plurality of listings for each available medication and an associated listing which includes information on possible alternative medications, whether a rebate or free sample is available for the alternative medications, among other information. 
     In one embodiment, the terminal  102  is a desktop computer  102  and, in other embodiments, the physician can access the system  100  using a portable viewing device  104 . Terminal  102  and server  106  will communicate using any conventional architecture, for example a client/server architecture where terminal  102  will execute a client application, e.g., a web browser, to access an application executing on server  106 . Terminal  102  will access server  106  to enable a user to transmit an identifier from a patient folder or physical record  120 . Server  106  will receive the identifier affixed to file folder  120  and use the identifier to retrieve the patient&#39;s record from the patient record database  108 . The identifier identifies the location of the patient record on remote server  106 . In one embodiment, scanner  114  will read the identifier, e.g., a barcode  122 , from the file folder and determine the patient record. In another embodiment, identification tag  124  will transmit a unique code to an electronic identification tag reader and/or any other type of device that can receive, store, and transmit information to a reader/receiver coupled to terminal  102 . Terminal  102  will include communication module  112  for communicating to remote server  104 . 
     Alternatively, the physician can access the system  100  using a portable viewing device  104  which may be carried by the physician while visiting each patient. In one embodiment, the mobile stand-alone device  104  contains a computer processor and a communications port, such as via Bluetooth™, Wi-Fi, Universal Serial Bus (USB™) cable, infrared, or any other data transmission system now known or to be developed. The physician can use the mobile stand-alone device  104  to recognize the identifier of the patient record. In one embodiment, the portable device  104  includes a reader for reading the identifier  122  or tag  124  associated with the physical patient record. The reader for reading the identifier includes but is not limited to a barcode scanner, a imaging device (such as a CCD encoding device), an electronic tag reader or any other known or to be developed device for reading and decoding an identifier or symbology located on the physical file folder. Once the identifier is read by the device  104 , the device  104  will transmit the identifier via the communications port to the server and the device  104  will present the patient record to the physician via a display device. The physician can then select a medication for the patient and subsequently be presented with an alterative medication along with any associated offers as will be described below. 
     Generally, when a physician desires to prescribe a medication for a patient, the physician will access the e-prescribing server  106  via a terminal  102 ,  104 . The physician retrieves a record associated to the patient by entering the name of the patient or entering a code associated or assigned to the patient, e.g., the identifier located on the patient record  120 . The server  106  will use the patient code or identifier while accessing the patient record database  108  to retrieve the patient record. Based on data in the patient record, the physician selects a medication for the patient. The e-prescribing server  106  will then access the e-prescribing database to determine if the medication has any alternative listings associated with it. If any alternative medications are available, the alternative mediations will be presented to the physician at the terminal  102 ,  104 . The physician will also be provided with any other information that is associated to the alternative medication, for example, if a rebate is available, if free samples are available, possible drug interaction warnings, etc. At this point, the physician can make an informative decision on which medication to finally prescribed to the patient. 
     It is to be understood that the present disclosure may be implemented in various forms of hardware, software, firmware, special purpose processors, or a combination thereof. In one embodiment, the present disclosure may be implemented in software as an application program tangibly embodied on a program storage device. The application program may be uploaded to, and executed by, a machine, e.g., terminal  102  or server  106 , comprising any suitable architecture such as a personal computer, a workstation or server. Preferably, the machine is implemented on a computer platform having hardware such as one or more central processing units (CPU), a random access memory (RAM), a read only memory (ROM) and input/output (I/O) interface(s) such as a keyboard, cursor control device (e.g., a mouse or joystick) and display device. A system bus couples the various components and may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus, and a local bus using any of a variety of bus architectures. The computer platform also includes an operating system and micro instruction code. The various processes and functions described herein may either be part of the micro instruction code or part of the application program (or a combination thereof) which is executed via the operating system. 
     In addition, various other peripheral devices may be connected to the computer platform of the machine by various interfaces and bus structures, such a parallel port, serial port or universal serial bus (USB). One such peripheral device may include a communications device, e.g., a modem, satellite relay, wireless connection, etc., for enabling communications from terminal  102  to various servers. Other peripheral devices may include additional storage devices, printers  111 ,  116  and scanner  114 . 
     It is to be further understood that, because some of the constituent system components and method steps depicted in the accompanying figures may be implemented in software, the actual connections between the system components (or the process steps) may differ depending upon the manner in which the present disclosure is programmed. Given the teachings of the present disclosure provided herein, one of ordinary skill in the related art will be able to contemplate these and similar implementations or configurations of the present disclosure. 
     Terminal  102 ,  104  and/or server  106  may operate in a networked environment using logical connections to one or more remote computers. The remote computer may be a personal computer, a server, a router, a network PC, a peer device or other common network node, and typically includes many or all of the elements described above relative to the machine. It is to be appreciated that network  109  may be a local area network (LAN), wide area network (WAN), the Internet or any known network that couples a plurality of computers to enable various modes of communication via network messages. Terminal  102 ,  104  may communicate to the server  106  and network  109  via any known communication link  107 , for example, dial-up, hardwired, cable, DSL, satellite, cellular, PCS, wireless transmission (e.g., 802.11a/b/g, etc.), etc. Furthermore, the devices will communicate using the various known protocols such as Transmission Control Protocol/Internet Protocol (TCP/IP), File Transfer Protocol (FTP), Hypertext Transfer Protocol (HTTP), etc. During a purchasing transaction, the computing devices may employ Hypertext Transfer Protocol Secure (HTTPs), Secure Sockets Layer (SSL) Protocol, Secure Electronic Transaction (SEC) Protocol, etc. 
     Referring to  FIG. 2 , flow chart illustrating a method for prescribing alternative medications in accordance with an embodiment of the present disclosure will be described. 
     Initially, a physician accesses the electronic database system to write an electronic prescription such as RxNt. The physician selects the applicable patient, in step  202 , and the applicable medication or alternatively the electronic system selects the medication, in step  204 . The physician, my select the applicable patient by entering identifier into terminal  102 ,  104  from the patient record  120 . Identifier may be the name of patient, the number convention that the files are identified by, etc. It is to be appreciated identifier may be placed on the patient record  120  itself or it may be placed on a tab. Identifier (a printed tab or handwritten tab) may be directly affixed onto the patient record  120  or placard. In one embodiment, identifier includes a bar code  122  or an alpha-numeric string. If identifier for the patient record  120  is handwritten or printed without a barcode, the entry into user terminal  102 ,  104  is manual. A manual entry could include any method now known or developed in the future including, but not limited to, using a keyboard, voice recognition software, etc. If the printed identifier has a bar code  122 , the code may be scanned via a scanner  114  coupled to the user terminal  102 . Terminal  104  may include a barcode type scanner or may employ a CCD type device to acquire the identifier from the patient record  120 . 
     In another embodiment, the patient record  120  also includes an electronic identification tag  124 . There are various types of electronic identification tags known in the art including, but not limited to, Radio Frequency Identification Device (RFID) tags, electric identification, and transponders of various types and any other type of device that can receive, store and transmit information. The tag  124  will includes an identification code indicating the associated physical file folder. The tag  124  will wirelessly transmit the identification code to the user terminal  102 ,  104  when the file folder is within a predetermined distance of the user terminal  102 ,  104 . 
     Based on the information stored in the patient record retrieved from database  108 , the physician will select the medication most appropriate for the particular patient. Alternatively, the e-prescribing server  106  will select the appropriate medication and present the selection to the physician at terminal  102 ,  104 . 
     Once the medication is selected, the e-prescribing server  106  checks the database  110  to see if there is an associated listing stored by a medication manufacturer for the selected medication, in step  206 . This listing may include information on an alternative medication, e.g. the physician or system selects Nasonex and the database  110  for Nasonex contains a flag to NasaCort that was placed there by the manufacturer of NasaCort. The NasaCort data includes information on a free sample of NasaCort that is available to the patient or physician. The associated listing (in this example information on the alternative medication NasaCort) is displayed on the users display terminal  102 ,  104 , in step  208 . 
     The e-prescribing server  210  will then check the associated listing to see if any offers (e.g., free samples, rebates, information, etc.) are available for the alternative mediation. If the offer from the manufacturer is a rebate, in step  210 , then the rebate coupon can be (a) printed and presented to the physician or patient at the physician&#39;s office or (b) emailed to the patient, in step  212 . Furthermore, the physician may provide an indication to the terminal  102 ,  104  where to e-mail the rebate to, e.g., an e-mail address of the patient that is stored in the patient record from database  108 . 
     If the offer from the manufacturer is a free sample of the medication, in step  214 , then the physician would indicate the address that he wishes the medication to be sent to or the address of the patient will be automatically retrieve from the patient record database  108 . Address possibilities would include the address of the physician or the direct address of the patient. Based on the alternative medication and associated offers, the physician can then make an informative decision on which medication to prescribe for the patient. 
     Furthermore, if the manufacturer wants to present the physician with information on the alternative suggested medication (in this case NasaCort) then the physician would be able to print out this information, or alternatively have the information e-mailed to him or to the patient. 
     In the above embodiment of the present disclosure, a drug manufacturer would have access to all the medications that are in the electronic prescribing database  110  and this manufacturer would be able to tag any of these medications with alternative medications and information including free samples, manufacturer rebates, and information on competing medications via medication manufacturer terminal  126 . In this embodiment, the medication manufacturer will access the e-prescribing database  110  via terminal  126  over secure protocols such as Hypertext Transfer Protocol Secure (HTTPs), Secure Sockets Layer (SSL) Protocol, Secure Electronic Transaction (SEC) Protocol, etc. including various layers of password protection to ensure the integrity of the database  110 . In this manner only authorized parties will be allowed to access the database  110 . Furthermore, the medication manufacturers may be restricted or limited, e.g., by assigned passwords or other means, to only access certain drugs for tagging. By example, a cholesterol lowering drug company such as Crestor could only tag cholesterol drugs. 
     In another embodiment of the present disclosure, the manufacturer would have a control panel, e.g., terminal  126 , that would allow him to remotely access and enter this information from his local processor to the remote database server  106  that is providing the electronic prescriber information. Of course the manufacturer could update the information and offers dynamically as often as he/she wanted. 
     In one embodiment, the medication manufacturer will be charged a fee via an e-commerce transaction per listing associated to a medication or per information update to the e-prescribing company running the system  100  or maintaining the server  106  and database  110 . In the above example, NasaCort&#39;s manufacturer Sanofi-aventis U.S. LLC would pay e-prescriber a fee for the offer for free samples, and another fee if offering a manufacturer rebate, and another fee if providing information on their product. Of course, such fees might be aggregated into one package fee depending on the program fees of the company running the e-prescribing system  100 . While this disclosure has been shown and described with reference to certain preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of disclosure of the appended claims.