Clinical Guideline Development

To complement your organization’s prior authorization system, Clinical Pharmacy Services develops clinical guidelines for those making coverage decisions on those drugs. We have a library of more than 400 guidelines.

Our clinical pharmacists have specialized training that enables them to search for, retrieve, evaluate, and interpret a wide range of published medical literature, including clinical studies, published literature, and advisories.

In addition to scanning all available clinical resources to develop guidelines for specific clients, we also take a proactive approach:

• Remain aware of clinical developments that could result in changes to guideline status
• Collaborate with you to ensure the resulting clinical guidelines reflect your organization’s unique needs
• Take physician viewpoints into account throughout the guideline development process

Our approach to guideline development is as follows:

• Align guideline with accepted best practices and available evidence-based information
• Present guideline to you for approval
• Monitor the impact of the clinical guideline for six months
• Evaluate whether the guideline works well
• Eliminate or redesign guideline as necessary

The guidelines are designed so they can be used either as internal review documents or within a published service guide, such as a web document. We also host forums and continuing education programs to provide clients with clinical updates.