Drug Utilization Management

The high-cost pharmaceuticals that require a health professional’s assistance in administration have stayed within the medical benefit (medical pharmacy). The majority of new biopharmaceutical products in late stage development require the assistance of a health professional for administration. Of these new pharmaceuticals, the majority will be covered under the medical benefit. MedRx can offer clients visibility and assist their physician network in applying best-practice guidelines to the practice of medicine with the following features:

• Production of medical pharmacy trend reports
  
  
• Management and administration of medical pharmacy clinical protocols and policies
  
  
• Application of prior authorization and excessive quantity edits to claim transactions
  
  
• Access to point-of-service data for approved disease management partners
  
  
• Management of off-label use for high-cost biologics