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Prescription Drug Safety
Ensuring Medications
We have several programs that protect your health by ensuring medications are prescribed in accordance with generally accepted medical practice. We also ensure the safety of the medications you and your family use through drug use review.
Patient Safety And Quality Monitoring
The Patient Safety And Quality Monitoring (PSQM) program is comprised of a set of clinically aligned programs currently in place that are designed to promote the safe and appropriate use of medications. Examples of this program include:
Prior Approval — requires that approval is obtained for certain prescription drugs and supplies before they are covered. A list of drugs requiring prior approval and the forms to be completed can be found on this web site under the Pharmacy Programs feature. Your physician may return the form by mail or fax it to the address indicated on the form.
Safety Checks — before your prescription is filled, we have put in place safety and quality checks to provide information on precautions or contraindications related to other drugs, patient age and sex. In addition these checks identify drug duplications, review for excessive use of medication and for refills that are requested too soon.
Quantity Allowances — we have established specific allowances for several medications. For examples of quantity allowance medications, please refer to the prior approval feature under Pharmacy Programs feature on this web site.
Drug Use Review
Both the Retail Pharmacy and Mail Service Pharmacy Programs review your prescriptions to monitor any problems that may occur. We look to make sure there are no problems or interactions with other medications you are using or disease conflicts. Messages about possible drug interactions are sent to the pharmacists while you are filling a prescription at a retail pharmacy and to the pharmacist filling your prescription at our mail service pharmacy.
We also make sure you are not getting refills too late or too soon. Either situation may indicate a problem or misunderstanding you are having with the instructions for taking the medication.
Education
We educate our network pharmacists through regular newsletters to keep them informed about the Service Benefit Plan prescription drug benefits. In addition, we communicate with both your physician and you about your drugs and the availability of special programs for certain diseases.
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