Jul 31, 2019

The monopolization of patient drug data

Illustration: Aïda Amer/Axios

Few things are more valuable in health care than data — specifically prescription data. Surescripts, a company that allows prescriptions to be filled electronically, controls a lot of that data and has every incentive to keep it gated.

Driving the news: Surescripts is asking the FBI to investigate allegations that one of its vendors illegally shared patients' medication histories with Amazon's online pharmacy, PillPack. It's a fight that highlights how difficult it has become for patients to share their own drug data and how incumbent players protect their turf.

How we got here: Surescripts contracted with a reseller called ReMy Health, which gave doctors, hospitals and other prescribers access to data on the drugs patients take or used to take.

Yes, but: Surescripts does not allow pharmacies to access medication history data. That means pharmacists, like those at PillPack, who want to verify someone's prescriptions have to spend the time calling and faxing doctors instead of going directly to Surescripts.

  • Here, Surescripts is alleging ReMy Health was sending that data to PillPack in violation of their contract and that PillPack was requesting data through providers who had never seen its patients.

Background: Surescripts has the backing of powerful players in today's drug supply chain and also has attracted attention for wielding its own market power.

  • Two of the largest pharmacy benefit managers, CVS and Express Scripts, as well as two trade groups representing drug stores own Surescripts.
  • SureScripts is facing a lawsuit from the Federal Trade Commission, which alleges Surescripts violated antitrust law by using its monopoly power to strong-arm pharmacies and other vendors into exclusively using its services.

"This action we are taking is purely and simply about maintaining trust on the network," Surescripts CEO Tom Skelton said in an interview, after being asked about how the firm's monopoly position factored into this dispute.

The other side: ReMy Health did not respond to requests for comment. A PillPack spokesperson said the company's patients give explicit consent to obtain medication histories.

  • "Given that Surescripts is, to our knowledge, the sole clearinghouse for medication history in the United States, the core question is whether Surescripts will allow customers to share their medication history with pharmacies and if not, why not?" PillPack said.

The bottom line: Something as simple as making sure someone is taking the right medications isn't that simple when there are billions of dollars up for grabs.

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