An E-Prescribing Overview

How routing, capture, and fulfillment actually work in 2025

Note: Like any market map or diagram, it is inherently wrong by virtue of depicting complex relationships and markets in visual fashion. Be kind in your corrections, it is illustrative only.

A few years ago, I wrote a popular thread about pharmacy fulfillment and e-prescribing. Time for updates.

The original story: paper prescriptions sucked (fraud, lost scripts, doctor handwriting), so we got our second nationally ubiquitous network (after clearinghouses) in e-prescribing via regulatory tailwinds and tremendous boxing out of competition by Surescripts.

On-ramps

Companies like DrFirst, Inc. and DoseSpot emerged offering developer-friendly APIs wrapping the underlying NCPDP mess. The space consolidated (DoseSpot acquired Bravado Health), but Veradigm® ePrescribe, RXNT, and MDToolbox exist at different price points. Consolidation continues as pure API arbitrage isn't sustainable long-term.

Truepill