Raising the Bar for Drug Utilization Review

Holistic Drug Utilization ReviewThe incorporation of drug utilization review in pharmaceutical cost containment strategies as a means for managing large claim pharmaceutical costs and injured worker outcomes is an industry-wide practice. However, existing “drug evaluations” yield sub-optimal analyses that neglect important factors. ANS Solutions believes drug utilization review plays a crucial role in improving the quality of care and life for injured workers. The lack of a truly comprehensive and effective program in the industry led to the development of ANS’s proprietary Pharmacotherapy Review program, the only face-to-face drug utilization review program of its kind.

A Better Drug Utilization Review Program

ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. Conducted by doctors of pharmacy and nurse experts working in conjunction, Pharmacotherapy Review ensures that prescribed treatment regimens are appropriate, medically necessary, and economically responsible. Pharmacotherapy Review is conducted in three stages based on a structured and comprehensive review of a patient’s current pharmaceutical treatment program as well as their entire medical history to achieve appropriate therapeutic decision-making and positive patient outcomes while also reducing costs.

Stage 1: PharmReview

Highly credentialed nurse experts conduct a thorough evaluation of an injured worker’s prescription data, medical history and existing course of treatment to ensure a clinically appropriate and injury-specific pharmacy regime is being followed.

Stage 2: PharmIntervention

Actionable and clinically appropriate recommendations derived from a holistic review of the injured worker’s treatment program are proposed face-to-face to the treating physician.

Stage 3: PharmCompliance

Ongoing management of the Pharmacotherapy Review program is critical to its overall effectiveness. An ANS Clinical Liaison officer ensures physician and patient adherence with the new prescription treatment plan.

Benefits of Drug Utilization Review Through Pharmacotherapy

The three stages of Pharmacotherapy Review result in changes to drug therapy that safely and effectively improve quality of care while lowering the overall cost of care by:

  • Preventing the use of unnecessary or inappropriate drug therapy
  • Identification and resolution of co-morbidities
  • Improving overall drug effectiveness
  • Ensuring physician and patient compliance

In addition to Pharmacotherapy Review, ANS provides an entire suite of services that allow payers to align other elements of care of the injured worker with the improved outcomes yielded by pharmaceutical cost management.

These services include:

  1. Legal Nurse Consulting
  2. Medical Cost Projection
  3. Reducing Medicare Set Aside & Part D Exposure

To learn more about how ANS can help you navigate complex Workers’ Compensation large loss claims, contact ANS today.