Utilization Management

Prescribing and using medications appropriately can effectively improve patient outcomes and reduce expenses, even as drug costs rise.

Nonprofit health care agencies, managed care organizations, and Medicaid programs manage drug utilization — and maximize the efficacy of their drug spending — with the help of UMass Medical School’s Clinical Pharmacy Services. Our utilization management services, which are customized to meet your individual needs, can help you target specific program areas.

• Use of Generic Drugs
  Our team designs and implements generics-first policies that reduce reliance on expensive branded medications and maximize savings.
• Outcomes Analysis
  Our quality assurance reporting enables you to track outcomes and evaluate the efficacy of your organization’s drug policies.
• Prescribing Pattern Analysis
  By evaluating physicians’ prescribing trends, we can identify areas that could be improved through educational intervention or cost-avoidance techniques.
• Data and Analytical Reporting
  Our customizable reports show medication utilization trends, prescribing patterns, and member profiles.
• Medication Regimen Reviews
  Our pharmacists examine a patient’s full profile when they review prior authorization requests and answer other coverage questions from providers and pharmacists.
• Retrospective Drug Utilization Review
  Through ongoing review of established drug policies, we adapt our formulary management strategy — in real-time and at the point-of-sale — as new drugs enter the market, standards of care change, or drug shortages occur.