Smarter Decisions, Superior Outcomes

Managing Off-Label Prescribing in your Pharmacy Benefit

Posted by Kathleen Sabo on February 21, 2018 at 9:00 AM

Antidepressants for alcoholism, oral contraceptives for menstrual disorders, stimulants for weight loss; all of these are examples of off-label drug prescription use. It's a common practice, but is it safe or is it misuse or even abuse? The answer is, that depends.

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Topics: Coverage Determination Process, Prior Authorization, Prior Authorization Processing, opioids, health plan management, population health, patient outcomes,, FDA drug approvals

3 Common Myths about Prior Authorization Carve-Out

Posted by Kathleen Sabo on February 15, 2018 at 10:49 AM

There are three common myths circulating in the employer benefits marketplace regarding prior authorization (PA) services:

  1. All PA Programs are the same.
  2. My PBM won’t let me.
  3. It’s too confusing for members.

In this article, we’ll explore and dispel those myths and provide
a glance at the value of carving-out these programs from the pharma
cy benefit management contract. Successful PA programs, when managed effectively, are the gatekeeper to controlling soaring pharmacy expenditures while ensuring the right patient gets the right drug in the right dose at the right time.

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Topics: High Cost Medications, Controlling Pharmacy Expenditures, pharmacy spend, Coverage Determination Process, Prior Authorization, Specialty Drug Cost Control, Prior Authorization Processing, health plan management, population health, healthIT, data accessibility, patient outcomes,, drug costs,, rising drug costs,

Monitoring PDMP Effectiveness Now and in the Future

Posted by Denika Hockenhull on May 16, 2016 at 10:30 AM

HID had the honor of leading honored a Vision Session during the 5th Annual National Rx Drug Abuse & Heroin Summit that was held March 28-31 in Atlanta, Georgia.

Titled “Monitoring PDMP Effectiveness Now and in the Future,”  HID’s presentation focused on how data accessibility and enhancement are effective tools for protecting public health and safety while supporting sound clinical prescribing, dispensing, and use of controlled substances. Attendees discovered:

  • How collaborative partnerships support state PDMP goals and outcomes
  • Why public and private health plans will require PDMP data
  • How the ONC’s Interoperability Roadmap will change the way PDMP data is accessed

Program Manager Rebecca Poston, MPH, RPH, was on hand to speak on the tremendous success accomplished by E-FORCSE, the State of Florida’s PDMP. E-FORCSE has experienced real, tangible, positive outcomes since 2010 when the program began and HID’s RxSentry solution was implemented.

If you've missed this year's Summit, don't worry. Our team has provided the presentation slides and a brief recap after the jump!

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Topics: Interoperability, state health, opioids, PDMP, population health, healthIT, data accessibility

Independent & Objective

Clinical expertise without the noise

Getting the facts matters. Following our corporate mission, we're committed to using this blog to enhance your knowledge of evolutionary events and discussions in the pharmacy services and technology arena. 

Here's what we're focused on right now:

  • Lowering ingredient cost
  • Enhancing the coverage determination process
  • Creating robust prior authorization criteria
  • Producing actionable drug trend analyses
  • Enhancing prescription drug monitoring 
  • Implementing interoperability efforts

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