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Article: Drug utilization audit looks at PBM priorities
- Article from:
- Managed Healthcare Executive
- Article date:
- February 1, 2004
- Author:
CopyrightCopyright Advanstar Communications, Inc. Feb 2004. Provided by ProQuest LLC. (Hide copyright information)
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Sioux Falls, S.D.-MCOs and their pharmacy administrators should negotiate and develop contracts promoting fiduciary responsibility from the pharmacy benefit managers (PBMs), according to an audit of client drug utilization data from Ameri-Pharm Pharmacy Services, a mailorder pharmacy provider.
"Contracts must include the ability of the MCO to effectively audit PBM claim data," says AmeriPharm's President Ron Bertsch, RPh. "The MCO should complete regular audits of prescription drug use to identify trends that indicate the PBM might be operating with principles not supporting cost containment."
Auditing of PBM activity is increasing in the marketplace, according to MHE Advisor Perry Cohen, ...