Member-Driven, Client-Focused, Pharmacist-Led Clinical Programs
TandemRx has developed a variety of clinical programs and services that have produced positive results for our clients’ particular goals.
Our strategic clinical partnerships collaborate with payers, doctors, pharmacists, and members. Using our proprietary technology, we seamlessly integrate medical, pharmaceutical and other data sources that are client specific to deliver safer, collaborative care and cost savings that benefit all.
Our team of pharmacists and healthcare professionals produce healthier outcomes by recognizing, resolving, leveraging and educating through personal connections.
By taking into account the member’s medical condition and history, we will validate that the medication, its’ period, frequency and dosage will promote positive outcomes and assess the member’s potential negative or allergic reaction before and during treatment..
We know that Prior Authorization encourages the appropriate and efficient use of medications by allowing coverage only when certain conditions are met while aid in controlling plan and total net cost.
We help to contain cost by requiring in certain therapeutic classes that the member try a lower cost alternative drug before using a more costly medication. In this situation it requires the attempt to attain a positive health outcome with a less expensive medication before the authorization for a more expensive drug.
We make recommendations in limiting the quantity dispensed of certain medications to minimize wastage and to ensure prescribing is consistent with FDA dosing guidelines.
Our Preferred Drug List contains both brand name and generic medications that have shown to be effective, safe and are regularly updated. The tiers are used to determine the member’s out of pocket cost or co-pays. These list are an important part for the prescribing physicians and members to help in containing the cost of the clients and members overall drug spend.
We use an evidenced based, cost effective quality of care approach and with physician approval, replacing original medication with chemically different but similar efficacy.
We deploy a proactive approach to new medications on the horizon by gathering important data to interpret and giving advice to aid our clients in their formulary program.
We recognize that certain medications are priced the same per unit regardless of the strength and this program focuses on members taking drugs twice daily that could be taking a larger dose (optimized) once daily and save the cost of the second dose that is no longer required.
By limiting certain branded drugs when there are already clinically sound alternative at a lower cost, our clients have reported considerable cost savings.
Our program ensures that the right medication is prescribed at the correct dosage for the proper duration, the patient must get the medication filled and adhere to the therapy, the patient must me be monitored to determine if the therapy and outcomes were achieved while adverse effects are avoided or minimized, and patients and caregivers are properly educated to ensure patients’ therapy is properly managed.
Our medication adherence program identifies and manages gaps in care. We use holistic, patient-centered and disease specific rather than focused solely on individual drugs or drug classes. These holistic programs are collaborative in nature and often including prescribers, pharmacists, disease management programs and other resources.
Our DUR programs play a key role in understanding, interpreting, the administration and use of medications and improving the prescribing process. Clients find DUR programs valuable because the results help foster a more efficient use of limited health care resources. DUR’s give us the opportunity to identify trends in prescribing among groups of patients with similar health states like diabetes, high blood pressure and asthma. With this data we can improve for individual patients and grouped populations the quality of care, enhancing therapeutic outcomes, and eliminate inappropriate pharmaceutical expenditures, while giving us a reduction in overall drug spending cost. DUR’s are classified in three ways:
- Prospective – evaluation of a patient’s therapy before medication is dispensed
- Concurrent – ongoing monitoring of drug therapy during the course of treatment
- Retrospective – review of therapy after the patient has received the medication