PDL and P&T Committee Support
Industry Challenge
Physicians are often targeted by pharmaceutical representatives and patients to prescribe drugs without regard to cost, especially when a third party is paying for the drug benefit. However, Medicaid program administrators facing high reimbursement costs need physicians to prescribe the most cost effective drug that is clinically efficacious. While cost is an important factor in selecting therapeutic alternatives, clinical factors are also critically important. Administrators know that physicians will disregard therapeutic alternatives that do not meet the clinical needs of the patient.
Solution
The concept and practice of developing a preferred drug list (PDL) has increased in use across the United States for approximately thirty years. The PDL―developed by a Pharmacy and Therapeutics (P&T) Committee of pharmacists and physicians―is now an essential tool in the management of prescription drug expenditures.
HID pharmacists assist the P&T Committee in identifying drug classes that provide the greatest cost savings without negative impacts on patient quality of care or outcomes. As a result of our extensive clinical expertise, exhaustive reviews of prior and current drug utilization, and national experience in this area, HID is poised to provide pertinent, up to the minute recommendations.
Features
- Recommendations for inclusion or exclusion of drugs on the PDL. HID pharmacists base their reviews on all available relevant information, such as changes in product labeling, peer reviewed literature, and recent clinical trials.
- Recommendations for drugs to be considered in clinical reviews. HID pharmacists base their recommendations to the P&T Committee based on American Hospital Formulary Service (AHFS), therapeutic class, First Data Bank (FDB) identifiers, or other drug classification systems used by the client.
- Information regarding new drugs. HID pharmacists provide information about drugs new to the market as well as drugs that the P&T Committee believes should be re-evaluated.
- Utilization data. As part of the PDL review process, HID pharmacists provide utilization data based on state and national trends in prescribing and dispensing that may be useful to P&T Committee members as part of the PDL review process.
- Projected cost savings. HID pharmacists provide projections of expected cost savings to support recommendations for inclusion or exclusion of drugs on the PDL.
- Clinical support. HID pharmacists develop applicable criteria for prior authorization, pro-DUR, and other programs that use the PDL.
- Informational materials. HID pharmacists provide information concerning the PDL to physicians and pharmacists.
- PDL support. HID pharmacists support the continued development and operation of the PDL by providing current clinical research for review by the P&T Committee and qualified staff.
- P&T Committee meeting support
- An HID pharmacist acts as the recording secretary for the meetings and provides detailed and comprehensive minutes for the client within two weeks after the meeting.
- An HID pharmacist notifies P&T Committee members of upcoming meetings, in collaboration with the client.
- An HID pharmacist receives, review and mail all materials to P&T Committee members and the client prior to P&T Committee meetings.
- An HID pharmacist facilitates the P&T meetings to ensure an orderly review of clinical information and prompt decision-making.
Benefits
By facilitating Committee operations, HID optimizes the involvement of clinical professionals on the P&T Committee. We provide the relevant information in a clear and concise format, so Committee members can quickly grasp the most important points and not waste time performing their own research. We also provide thorough, complete drug monographs for professional reference.
Most importantly, HID’s reputation and clinical approach to PDL development have helped us earn the support of the prescribing physician community—a critical factor in ensuring the success of any PDL program.
For more information on how HID’s PDL and P&T Committee support can help your organization, contact us.