Magazine article Drug Topics

DPS Pays for Pharmacists' Interventions in Oklahoma

Magazine article Drug Topics

DPS Pays for Pharmacists' Interventions in Oklahoma

Article excerpt

Bit by bit, pharmacy benefit managers (PBMs) appear to be testing more options to pay pharmacists to intervene with patients' drug therapy. One such option is an H sub 2 blocker (antiulcer drug) intervention program rolled out this summer in Oklahoma by Diversified Pharmaceutical Services, a PBM based in Minneapolis. The program impacts patients in one client's health plan, which DPS declined to identify.

As explained by Diane Hillbrant, R.Ph., senior director of provider services at DPS, here is how the program works:

First, DPS scans its database of patients in a health plan to see which ones have been using a high-dose form of H sub 2 blocker for an extended period of time. The next time one of these patients calls in or appears at the pharmacy for a refill and the pharmacist submits the claim for approval, DPS sends back a notice asking the pharmacist to see whether a lower dosage form of the prescription drug could be used instead.

The pharmacist consults with the patient and/or the patient's physician, then keys in a response, on-line, indicating either that the lower dosage has been substituted or that a decision has been made to continue the higher dosage strength-and why. The on-line codes used for submitting this information are ones developed by the National Council for Prescription Drug Programs (NCPDP), Hillbrant said.

For each high-dose prescription changed to a low-dose Rx, the pharmacist receives compensation at a flat rate. Hillbrant said it would be nice to be able to compensate pharmacists simply for consulting with patients and their physicians regarding the use of high dose H sub blockers. …

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