Merck-Medco Managed Care is fighting to distinguish its mail-order business from the services offered by "dot-com" pharmades, as Stephen Gold, vp./e-commerce, strategy, and delivery, calls the on-line pharmacies. "I think the online drugstores are more analogous to brick-and-mortar-pharmacies than they are to PBMs," he told Drug Topics during the National Managed Health Care Congress in Atlanta in late March. "The only place where our interests are potentially common is on the dispensing side. After that, we're in different areas."
Where the on-line pharmacies generally focus on "e-commerce," companies like Merck-Medco concentrate on "managing the pharmacy benefit, managing costs, treating patients properly, getting good outcomes, and getting good results," Gold said. "We can influence patient behavior, we can influence behavior of the doctor, and we're tasked and equipped to manage [pharmacoeconomic changes]." Still, he acknowledged that on-line pharmacies reflect the potential the Internet has to improve patient access to pharmacy, and vice versa. And Merck-Medco isn't the only PBM to take notice; Express Scripts announced it would launch YourPharmacy.com, its own on-line pharmacy, in the second quarter of this year
"All in all, we think the direction things are heading in is excellent, in terms of opportunity. But [we also have] a set of responsibilities. [We've used] those responsibilities to drive our strategy [for] Internet capability to date, and we're going to continue to build it into the future."
Rather than viewing the Internet simply as a vehicle for moving product, the company plans to expand its communication capabilities with specific "audiences," such as seniors or patients with specific disease states. Demographics point to the validity of that strategy; more than 22 million Americans reported using on-line health and medical content in 1998up from 12 million in 1997. More than half say they are interested in managing health insurance benefits on-line; 23% say they would buy prescriptions on-line.
Merck-Medco ran a pilot program to test its Web site for six months in 1998; the site was launched in October of 1998. Gold said "thousands" of Rxs are now filled through the site daily. But members of Merck-Medco plans are using the site for more than filling Rxs. Gold was predicting more than five million "hits" in March alone. And that's right in line with the company's objectives.
"We want the site to ... [focus] on two things," he continued. "One is pushing information to the patientas opposed to them having to pull it; the second is personalizing the site so that [patients'] health-care experience with us is more customized to their specific needs." He emphasized that the site, ultimately, should also offer the opportunity to enroll and participate in health management programs.
Gold acknowledged that it is too soon to conclude that Merck-Medco's site, or on-line pharmacy in general, will be successful. It will take "years and years" before there are enough data to assess its impact on patient compliance and outcomes.
The biggest obstacle to seeing such systems fulfill their potential, said Gold, is "penetration to the end user." The population segment with the highest drug spending (seniors) also has the lowest rate of Internet use, he said. The electronic media industry predicts those numbers will change as the bulk of the population ages and computers become even more pervasive. He said that helping users become more comfortable with security precautions, such as taking strong measures to validate the identity of each on-line user, should also ease consumer concerns and open the door to growth.
Harris Fleming Jr.
[Sidebar]
STRANGE Rx STORIES
Under pressure
Our pharmacy has an automatic BP/pulse machine for customer use. Recently, we had two teenage girls shopping in our department. One girl sat down at the BP machine and was patiently and quietly sitting for a few minutes. The other girl came over and asked her what she was doing there. She said, "Shh!! I'm waiting for my blood pressure and pulse." The directions on the machine were to sit quietly and wait a few moments for your reading. To the embarrassment of the young girl, she had not put her arm in the cuff or pushed the start button. She thought all she had to do was sit there and wait! We had a real good laugh about this incident for several days.
Frank Pawlus, R.Ph.
Anchorage, Alaska
If you have a "Strange Rx story," send it to Drug Topics, Strange Rx Stories, Five Paragon Drive, Montvale, N.J. 07645-1742.
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