Section 08: Pharmacy
Pharmacies are fully committed to ePA solutions. As many PA requests are still initiated at the pharmacy, ePA can relieve pharmacists of administrative burden while often helping patients leave the pharmacy with prescriptions in hand.
Learn the benefit of ePA for pharmacies
Acceleration in time to therapy through ePA depends on two-way electronic transmission of information between pharmacists and providers. Increased provider adoption of ePA solutions can shorten turnaround time for the PA process, allowing pharmacists to dispense prescriptions quickly with time to counsel patients on medications.
New ePA technologies for pharmacies are now fully-automating the PA process to intelligently start requests for prescriptions when a claim is rejected. Such ePA innovations are reducing time to therapy for patients and reducing workload for burdened pharmacists.
In fact, 76 percent of pharmacists report that automated ePA solutions make their job easier.45
As specialty drug spend is on the rise, utilization of ePA solutions in specialty pharmacies will be important for streamlining the complicated PA process.
Pharmacy Availability
Percentage of the pharmacy market, representing the majority of market share by prescription volume, committed to an ePA solution.46
| Pharmacy Chain | Committed | Available |
| Ahold | ||
| Albertsons/Safeway | ||
| Costco | ||
| CVS Specialty | ||
| CVS/pharmacy (Retail) | ||
| fred's Pharmacy | ||
| Good Neighbor Pharmacy | ||
| Health Mart (McKesson) | ||
| Kmart | ||
| Medicine Shoppe International/LeaderNet | ||
| Publix | ||
| RiteAid | ||
| Southeastern Grocers | ||
| Walgreens | ||
| Walmart (includes Sam's Club) |
Pharmacy System Vendors
There exists a wide range of functionality available from ePA vendors. A comprehensive solution meets the needs of all stakeholders while creating an efficient, in workflow solution for providers and pharmacists. The wrong solution could create administrative waste, varying workflows based on the health plan associated with a PA request, cause confusion between stakeholders and hinder a patient getting the medication they need to be healthy.
| Pharmacy System Vendor* | Committed | Available |
| AbacusRx | ||
| AdvanceNet Health Solutions | ||
| Best Computer Systems | ||
| CarePoint | ||
| Cerner | ||
| ComputerRx | ||
| Cost Effective | ||
| CPR+ | ||
| Creehan | ||
| DAA | ||
| DATASCAN | ||
| DigitalRx | ||
| FSI | ||
| HBS, Inc. (RxGENESYS RxAXIS) | ||
| Kalos | ||
| Key Centrix | ||
| Lagniappe Pharmacy Systems | ||
| Liberty Computer Service | ||
| McKesson (Pharmaserv) | ||
| McKesson (Pharmacy Rx) | ||
| McKesson (Enterprise) | ||
| Micro Merchant Systems | ||
| PDX (Classic EPS) | ||
| Pioneer Rx | ||
| PK Software | ||
| Prodigy Data Systems, Inc. | ||
| QS/1 | ||
| RNA | ||
| Rx30 | ||
| ScriptPro | ||
| Speed Script | ||
| SRS Pharmacy Systems | ||
| SuiteRx | ||
| SWI Softwriters, Inc. | ||
| VIP Computer Systems |
*If your pharmacy system vendor is not currently listed, please contact our team at epascorecard@covermymeds.com
Vendor Assessment
It is important to understand how an ePA vendor will accomplish key goals needed to successfully complete PA requests. The wrong solution could create administrative waste, cause confusion between stakeholders (payer; pharmacy; provider) and hinder a patient getting the medication they need to be healthy.
Does the ePA vendor provide a financial model that benefits the entire healthcare network?
The market stands to save billions of dollars when all stakeholders, especially providers, adopt ePA solutions at scale. Financial models that are free for providers and pharmacists encourage ubiquity and are therefore in the best interest of all stakeholders.
Does the ePA vendor technology support APIs?
The technology for ePA solution will grow and change with the industry; therefore, API support makes it easier for technology teams at EHR, payer and pharmacy systems to quickly implement new and optimized ePA solutions. Documented, standards-based ePA APIs will be a key to driving adoption in the market.
Key Takeaway
All pharmacies by market share have now integrated with an ePA solution. For pharmacists to return the most value from ePA, provider participation is crucial.
