IT Helps Manage Cipro Demand

Computerworld - Managed health care and pharmacy services providers are turning to their IT systems to manage spikes in demand for the anthrax antibiotic Cipro. Their mammoth rules-based databases help ensure that people receive what they need while guarding against unnecessary stockpiling.

These providers emphasize that they are managing the demand for Cipro no differently than that for any other drug. And they say prescriptions for other, far more common drugs still outpace those for Cipro.

Cipro manufacturer Bayer Corp., a Pittsburgh-based subsidiary of Germany's Bayer AG, didn't respond to repeated requests for comment. But John Maesner, vice president of pharmacy operations at Cigna Health Care, a Bloomfield, Conn.-based unit of Cigna Corp., said the number of prescriptions for Cipro, even with the anthrax scare, "is not even in the same league" as the demand for allergy drugs.

Maesner did confirm, however, that Cigna Health is using its rules-based systems to carefully monitor demand for the drug. Rules-based systems allow user-defined parameters to be built into the system, enabling end users to perform specific functions.

Those systems flag transactions "that might be inappropriate, such as stockpiling Cipro," Maesner said. He explained that when a customer presents a prescription for fulfillment at a brick-and-mortar or online pharmacy, the rules databases first check simple things such as eligibility and the qualifications of the person who wrote the prescription.

Built-in logic and rules also compare the dosage prescribed against U.S. Food and Drug Administration guidelines for the maximum dosage for that drug. It also performs a check of other drugs a person may be taking to ensure that there are no dangerous interactions, Maesner said. Cigna Health was unable to provide more technical details about the system before deadline.

Merck-Medco, the Franklin Lakes, N.J.-based pharmacy benefits management unit of Merck & Co., has entered into its rules database the guidelines from the Centers for Disease Control and Prevention that describe the use of Cipro to treat anthrax, according to spokeswoman Anita Kawatra.

Merck-Medco has used its system to track spikes in Cipro prescriptions over the past month, with volume doubling to 18,000 per day on Oct. 12. Merck-Medco had no problem handling this jump in volume, Kawatra added, since its Web site handles 160,000 prescriptions per week through 12 fulfillment pharmacies the company operates.

Kawatra declined to provide any details of the Merck-Medco IT systems, saying they provide the company with a competitive advantage it doesn't want to jeopardize.

Mike Davis, an analyst at Gartner Inc. in Stamford, Conn., said he wasn't surprised that Merck-Medco declined to detail its system architecture, since that would provide an insight into how much it cost and whether the company has achieved a payback. Davis said it would be "exceptional" if Merck-Medco has started to reap the financial benefits from its online system. But he added that in the health care field, "every company is going to have to go that way if they want to survive."