Drug Care - maximizing your benefits
Pharmacy Benefit Management
Concurrent Drug Utilization Review
Real-time claims adjudication benefits all parties. The prescription is analyzed based on data collected from all pharmacies before it is dispensed.
The prescription is compared to the patient history:
- duplicate prescription
- duplicate therapy
- drug interaction
- compliance - too early or too late refill
- incorrect dosage, gender, age
Cost control:
- patient eligibility
- coordination of benefits
- drug formulary
- ingredient cost and mark-up price limits
- dispensing fee limits
Prospective Utilization Review
The detailed data captured by the claims system can be used to project future experience.
- formulary management
- targeted intervention
- health information
- project mortality &: morbidity
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