Apoteket, Sweden’s largest pharmacy chain, and Medco Health Solutions, Inc. recently announced the development of Elektroniskt ExpeditionsStod (EES), one of the first national centralized drug utilization review (DUR) programs outside of the United States. This program is intended to improve prescription safety by reducing adverse drug events and thereby reducing the drug related hospitalizations. In Sweden, about 30 percent of emergency care visits and 10 percent of all hospital admissions are the result of preventable adverse drug related events.

EES will be owned and operated by Apotekens Service AB, a national pharmacy infrastructure supplier for the Swedish health care system. The system was integrated into ten pharmacies as a pilot in mid-October and will be available to all pharmacy locations throughout Sweden in early 2010. Medco partnered with Apoteket to develop the system and will have an ongoing role in supporting the national program.

Medco, which has one of the most sophisticated drug safety systems in the world, has adapted and reengineered its system with Apoteket to develop a superior system. Each time a prescription is ordered in Sweden and patient consent is obtained, it will undergo an automatic rules-driven review that examines a patient’s complete medical history to identify any potential danger of the new prescription interacting with other medications or aggravating existing medical conditions.

During the pilot phase, the prescription drug review has led to a dialogue between the pharmacist and the patient more than one-third of the time. As a result of the new system, the prescribing physician has canceled numerous prescriptions, dosages were lowered, or the original prescription was changed to a different drug.

EES enhances safety features that are provided by electronic prescribing, which has been proven to reduce drug errors. Sweden leads Europe in the adoption of e-Prescribing with approximately 80 percent of all prescriptions in the country being ordered electronically by physicians.

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