Q: Where does the data come from?
A: Data in the Prescription History Report (PHR) comes
directly from the nation’s Pharmacy Benefits Managers. (PBM’s)
Q: What is a Pharmacy Benefits Manager?
A: PBM’s have been in existence for more than
20 years and are huge databases that contain data on over 80% of the prescriptions
written in the United States. They are privately owned by Fortune 100 firms
in both the pharmaceutical and insurance industries. Both pharmacies and
insurance companies including Medicare and Medicaid voluntarily upload prescription
data daily into the databases.
Q: What do the PBM’s do with this info?
A: PBM’s were created for tracking
internal industry information such as trends, analysis, etc. Many insurance-related
industries have databases such as this including the life insurance industry
and the auto insurance industry.
Q: Why haven’t I heard of this data
before?
A: PBM’s haven’t allowed
this data to be used for outside purposes until recently. They allow the
data to be distributed in only two verticals: Healthcare and Legal.
Q: Is this Protected Health Information (PHI)
under HIPAA?
A: Yes. As such a signed HIPAA authorization
is required in order to have the information released.
Q: What information does the PHR report contain?
A: It contains information on the prescribed drugs,
dates the prescriptions were filled, dosages, contact information of prescribing
physician, and contact information of pharmacy where filled.
Click here to see a sample pdf file of the report.
Q: What information is required to submit
a PHR order?
A: First and Last name (maiden name when applicable),
DOB, SSN, Zip Code of residence, Gender and a standard HIPAA compliant Authorization
requesting medical records.
