Managed Care Pharmacy Issues

Sponsored webinar that provided an overview of insomnia disorder and the current challenges in adequately treating patients.

AMCP webinar that reviewed a summary of discussions from this summit.

AMCP webinar that reviewed a summary of discussions from this summit.

AMCP CEO Blog: With PA so often misunderstood, perhaps we need to do a better job of explaining this tool to the general public. For example, we might provide an example of how PAs are applied to opioids as additional safeguards to ensure their appropriate use. Or how a PA might be applied to botulinum toxin to ensure the prescription is for medical, rather than cosmetic, purposes.

Recognizing the widespread and devastating nature of the opioid crisis, AMCP formed the Addiction Treatment Advisory Group in 2015 based on the recommendation from the AMCP Partnership Forum, Breaking the Link between Pain Management and Opioid Use Disorder.

AMCP CEO Blog: We live in an interconnected world where the marketplace for all things is global. But we must also make sure the global system works for the benefit of the patients we serve. That includes taking steps to ensure the long-term stability and integrity of our critical pharmaceutical supply chain.

The purpose of this paper is to explain how managed care organizations (MCOs) are able to secure lower drug prices from pharmaceutical manufacturers as part of an effort to control drug expenditures.

Over the past several years, the introduction, utilization and cost share of specialty pharmacy products has been increasing at a rate substantially greater than that of other pharmaceuticals. This paper examines the characteristics of specialty pharmaceuticals; the growth of new expertise to handle and manage these pharmaceuticals; and the needs these products create for patients, health plans and practitioners.

Drug utilization review (DUR) is defined as an authorized, structured, ongoing review of prescribing, dispensing and use of medication. DUR encompasses a drug review against predetermined criteria that results in changes to drug therapy when these criteria are not met.

E-prescribing is the use of health care technology to improve prescription accuracy, increase patient safety, and reduce costs as well as enable secure, real-time, bi-directional, electronic connectivity between clinicians and pharmacies. This is achieved by providing prescribers with a secure means of electronically accessing health plan formulary, patient eligibility, and medication history at the point of care and securely transmitting the prescription electronically into the pharmacy’s computer system.

Formulary management is an integrated patient care process which enables physicians, pharmacists and other health care professionals to work together to promote clinically sound, cost-effective medication therapy and positive therapeutic outcomes. Effective use of health care resources can minimize overall medical costs, improve patient access to more affordable care and provide an improved quality of life.

Medication errors are among the most common medical errors, harming at least 1.5 million people every year. The extra medical costs of treating drug-related injuries occurring in hospitals alone are at least to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs.