Three Prescribing and Dispensing Steps Impacted by the Drug Compendia

The electronic drug record is becoming more important with each drug approval and launch.  Most drug records remain static because the prominent attributes of a drug product (active ingredient, dosage form, route of administration, and strength) do not change.

The static nature of the drug listing can lead to unwanted consequences for a drug product.  These are the 3 areas that are most impacted by the drug compendia listing.

  1. Prescribing – Electronic prescribing continues to grow. To create a new electronic prescription, prescribers need to perform an “alpha” search for the intended product utilizing the drug compendia data in the EMR/EHR system.  Issues arise when the prescriber needs to differentiate between multiple dosage forms or delivery devices for a product.  Challenges can occur when a system limits the number of characters displayed and does not permit an accurate depiction of the product, which is needed for proper selection.  Consequently, prescriptions are not being written for the intended drug due to difficulty selecting the product electronically.
  1. Product selection at the pharmacy – The prescription is written for a brand and the pharmacy system prompts the pharmacy staff to use a generic product option for dispensing. This is generally business as usual in retail pharmacies but may not be appropriate in the case of a brand that is a line extension placed in the same classification (GPI or GCN) as the original brand.  In this case, the generics available may only be substitutable, or A-rated, to the original brand.  The issue is that the generics are not bioequivalent or therapeutically equivalent to the brand line extension, and the pharmacy system did not take that into account when it displayed the substitution options.  Consequently, prescriptions are lost due to the lack of a unique classification for the brand line extension.
  1. Product dispensing and reimbursement – The product is packaged as a 2-pack, which is intended to be the entire prescribed therapy. Issues occur when the technician and pharmacist mistakenly believe only one should be dispensed and the package is broken instead of dispensing it as a unit.  The pharmacy would be overpaid for the product if the PBM reimburses the pharmacy at the package price.  The patient would require a refill but be told it is too soon for the insurance to cover it and could be forced to pay cash.  If the remaining 1-pack is not dispensed again, it could expire and be returned to the manufacturer.  The consequences include pharmacy partners experiencing payment, inventory, patient therapy and outcomes issues, and increased returns processing.

 

Each of these issues can be avoided.  Through forecasting the drug compendia listings and identifying potential challenges before they happen; actions can be taken to avoid or mitigate challenges.

Contact PHSI today to discuss your drug compendia concerns and challenges.  PHSI will review the drug and collaborate on communications with the drug compendia to document the proposed vision.  The optimal time to consider this review is prior to product approval and launch.

PHSI offers many services regarding the drug compendiaContact PHSI with your drug compendia questions!

 

Posted: May 2019

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