a process that yields the Best Results
Sargent & Associates Pharmacotherapy Review Program works in conjunction with your states utilization review process. These reviews offer a comprehensive pharmaceutical cost containment process and determination for medical necessity. We utilize a three step process:
Collection of medical documentation and submission for the pharmacotherapy review
Pharmacotherapy Review results are provided to a case manager to communicate or meet with the prescribing physician to review.
Report that Summarizes the outcome with recommendations
The end result can be a cost effective treatment regimen that supports the quality of care for injured workers.
Sargent and Associates utilizes specialist in anesthesiology as well as pharmacists to review the medical documentation. These Pharmacotherapy Reviews apply evidenced-based methodology for large loss cases in order to determine which alternative therapies should be recommended. Sargent and Associates is able to present actionable treatment modification recommendations in a written proposal to treating physicians. We utilize RN Case Managers to speak with and in some cases meet with the prescribing practitioner. The goal of this interaction based on the recommendations provided is to:
•Consolidate and coordinate the drug therapies that may be prescribed between multiple providers.
•Consideration of alternate therapies
•Utilizing case management strategies in the offering of weaning programs for over-prescribed narcotics
•Use of generics where applicable
Pharmacotherapy Prescriber Intervention
Sargent and Associates provides the results in advance to the prescriber and then attempts to speak with or meet with the prescribing practitioner to obtain a signed agreement. The RN case manager has been highly effective to deliver the recommendations of the Pharmacotherapy Review Report in collegial, face-to-face meetings with treating physicians. The objective of this approach is to achieve consensus on a modified medication regime and to obtain commitment on a future course of treatment.
Physician and patient adherence to the Pharmacotherapy Review Program is crucial to ensuring hard dollar cost-savings and positive therapeutic outcomes. Once the physician has agreed to the executed recommendations put forth in the report the agreement form is then provided to the adjuster and their internal case management department to ensure compliance with the new prescription treatment plan.