blog imagePersonalized  Precision Rx

Pharmaceutical Management Programs

  •  Managing personalized formulary/case management/pre-certification
  • De-scribe rather than prescribe when appropriate
  • Utilization of Manufacturer’s patient programs
  • Access available discounted contract pricing
  • Incentive to move to generic alternatives / bio-similar products
  • Managing channel for specialty drugs where drug is administered Hospital/clinic/drop ship through case management.
  • Economical International purchasing options
  • RX auditing for prior claims
  • Contracting a pharmacy network
  • RX discount card for non formulary items
  • Pharmacogenetic testing to determine what drugs are most effective preventing ADE

Our approach to managing pharmacy benefits is based on lowering total health care cost, not just pharmacy costs. We align our decisions with our clinical and disease management programs. As an integrated medical and pharmacy benefit provider, we will not make decisions that positively impact pharmacy costs at the expense of total health care costs. It is also our goal to continue to offer members broad options in each therapeutic class.