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VALUE HEALTH's DURbase COMPUTERIZED DRUG UTILIZATION REVIEW SYSTEM NOW HANDLING DATA ON 10 MIL. PATIENTS, GENERATING 10,000 MD ALERTS PER MONTH

Executive Summary

DURbase, the computerized utilization review system operated by Health Information Designs, Inc., is now reviewing patient records for over 10 mil. people and generating over 20,000 drug prescribing alert notices per month, according to ID's parent Value Health. Value Health President robert Particelli maintains that DURbase patient can "cut in half drug-induced hospitalizations" and can "reduce for a typical sponsor hospital admissions by 3.5%." Patricelli reported on the growth of DURbase during a Sept. 14 presentation at a seminar in New York City sponsored by the Wilkerson Group. Background information on the system notes that DURbase has grown from 1 mil. patients in 1984 to over 7 mil. in 1987 to the 10 mil. figure cited by Patricelli. The company predicts that it will provide the service to 5% of the U.S. population by 1990. HID lists 13 states among it DURbase clients, including the New York and Pennsylvania pharmaceutical assistance programs for the elderly. Pharmaceutical Card System (PCS) and the Health Care Financing Administration (HCFA) are also listed in the current client base. The extension of Medicare coverage to outpatient drugs and the government's related interest in drug utilization review provide the potential for major growth for the program, Patricelli indicated. "The real payoff [for a client] is in the avoided incidence of inpatient and outpatient care," he said. Patricelli estimated that the program has a cost-benefit ratio of 15:1 or 10:1 for a person under Medicare. Noting that DURbase generates 20,000 alerts monthly to prescribing physicians, Patricelli said that of the 50-60% of responding physicians, 70% change or discontinue the conflicting drug regimen. "This program pays for itself in the drug cost alone that it saves," Patricelli emphasized. DURbase "integrates claims information into a consolidated patient file and then passes that information over algorithms for 170 drug and disease categories using markers based on changing drug dose and diagnosis," Patricelli explained. Value Health, which purchased HID in late 1987, is looking to tie the drug utilization database into the company's Medicost preferred provider pharmacy organization. According to Patricelli, Medicost is installing terminals in pharmacies that will "permit, within a very brief period of time after point of sale, information going back to the prescribing physician to avoid conflict." Medicost is based in Southfield, Michigan. Through the first quarter of 1988, the firm said it had roughly 600 pharmacies in its PPO network ("The Pink Sheet" April 11, T&G-9). At the end of the summer, the company made a top management change, with Lee Morse replacing ex-PCS exec Ira Sharenow as president. In addition to DURbase, HID has dveloped Compass, a post-marketing surveillance data-base used by FDA and pharmaceutical companies including Hoffman-LaRoche, Sandoz, Schering-Plough, Ciba-Geigy and SmithKline. Patricelli told the cnference that through "the drug utilization review program we have logitudinal data on about 8 mil. people on drug and disease bases. We sell that to manufacturers for a whole variety of studies -- adverse drug studies for the manufacturers." Patricelli also noted that HID has begun talking to IMS about the incorporation of the DURbase material with IMS material "for pharmaceutical marketing purposes."

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