Physician and Pharmacist Drug Review
Rapidly escalating pharmacy costs now represent almost 20% of medical expenditures, a number that is climbing yearly. Employers have found themselves challenged to identify and implement solutions for this growing concern.
Many employers have initiated Pharmacy Benefit Management Programs (PBM) for assistance in reducing the cost of medications and ensure generic substitution wherever possible. However, these programs have not been as effective as originally intended.
Studies conducted by the National Council on Compensation Insurance clearly indicate the primary importance of utilization as the driver of workers’ compensation drug costs. Payers focused on managing utilization have seen their drug costs drop while payers without strong utilization controls consistently see drug costs increase.
To assist you and your PBM, we have developed the CID Detox program to examine your claims and ensure the medical appropriateness of the prescriptions, as well as the cost effectiveness of the dispensed medications. We utilize our proven technology to provide you an independent network of Physicians and Pharmacists who:
- Provide immediate cost savings strategies
- Contact the treating physician to discuss the review, if appropriate
- Provide your claims administrator with a report containing recommendations
We invite you to learn more about our successful experiences in assisting workers’ compensation organizations with pharmacy reviews and drug utilization reviews for claims management or for Medicare Set-Asides.