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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.
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.
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).
- 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%.