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Related Experiment Videos

Community pharmacist interventions in a capitated pharmacy benefit contract

K K Knapp1, H Katzman, J S Hambright

  • 1School of Pharmacy, University of the Pacific, Stockton, CA 95211, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|June 17, 1998
PubMed
Summary

Managed care pharmacies documented interventions for prescription issues, with drug selection problems being most common. A benchmark intervention rate of 4% was proposed, highlighting potential cost savings from prescription changes.

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Area of Science:

  • Pharmacy Practice
  • Managed Care Pharmacy
  • Health Services Research

Background:

  • Managed care organizations (MCOs) rely on efficient prescription processing.
  • Pharmacist interventions are crucial for identifying and resolving prescription-related problems.
  • Understanding intervention rates and types is key to optimizing patient care and cost-effectiveness.

Purpose of the Study:

  • To analyze documented pharmacist interventions in a managed care setting.
  • To propose a benchmark for intervention rates based on ideal pharmacist performance.
  • To determine the economic impact of drug selection interventions.

Main Methods:

  • Retrospective analysis of 595 interventions from 31 pharmacies serving 22,000 Medi-Cal patients.
  • Categorization of problems (drug selection, clinical, prescribing errors, patient education) and actions (e.g., contacting prescriber).

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  • Comparison with ideal performance data to establish a benchmark intervention rate.

    • Main Results:

    • Drug selection issues accounted for 50% of all problems identified.
    • Contacting the prescriber was the most frequent action (56.1%).
    • The overall intervention rate was 0.7%, with significant variability (0-4.1%) across pharmacies; a 4% benchmark was suggested.

    Conclusions:

    • Community pharmacies in managed care settings have inconsistent intervention rates.
    • A benchmark of 4% intervention rate is proposed as reasonable for managed care.
    • Prescription changes due to interventions resulted in an average cost reduction of 65.8%.