Rhode Island, Surescripts track flu-like activity to monitor prescriptions, use of Tamiflu

WARWICK, R.I. —Early published reports suggested that the Rhode Island state government had partnered with electronic prescribing network Surescripts to track the spread of the H1N1 influenza, but David Gifford, director of the Rhode Island Department of Health, said that wasn’t the whole story.

“The report around what we’re doing was a little misconstrued,” Gifford told Drug Store News, saying that the tracking system was a method for tracking “influenza-like activity.”

Gov. Donald Carcieri announced in late October that Rhode Island had launched a new system for using prescription data to track swine flu, but Gifford said the real utility was that it allowed the state health department to monitor prescriptions, and use of Roche’s Tamiflu (oseltamivir) and other antivirals, to identify and prevent such possible problems as shortages, over-prescribing and improper use by patients.

“It really helps us understand the supply-and-demand side,” Gifford said. “We can actually look at the prescribing of Tamiflu by age group and see how that mirrors the reporting of influenza.”

For example, Tamiflu must be taken within one or two days of the onset of symptoms in order to be effective, but by using Surescripts data, the department of health found that 15% of patients had waited five days after receiving prescriptions for the drug before filling them. When the health department got the word out that Tamiflu had to be taken earlier, Gifford said, the number of prescriptions filled late went down.

The department also can track use of the drug by different age groups. Tamiflu doesn’t work for seasonal flu, and H1N1 doesn’t affect the elderly as much as it does younger people, so if the department sees a lot of elderly people filling scripts for Tamiflu, it can warn them and their doctors to stop.

“I can start messaging, tell them to back off and use something else,” Gifford said.

As for tracking the spread of the flu itself, the department uses such traditional methods as weekly reports from physicians’ offices and data on school absences.

Gifford said the system theoretically could be used to track other drugs as well, particularly drugs with limited supplies used to treat specific diseases, such as diabetes medications, but that the department would stick with the flu for now.

“We’re keeping our head above water for H1N1, and we’re figuring out all the different ways we can use this for Tamiflu,” Gifford said.