Thinking outside the pillbox
Your Off Script consultant pharmacist strives to be your ally, who thinks outside the pillbox:
> To help you achieve your goals
> To help you focus on your top priorities
Your success is my success! Read Off Script's success stories.
The solution to your money problems and gene troubles
JR was concerned about the high copay for Brilinta, a blood thinner.
Clopidogrel is a less expensive and equally effective alternative
- if JR's body can normally break down the drug.
Fortunately, JR's genetic test revealed that he breaks down clopidogrel as expected.
Therefore, with the doctor's authorization, JR's Brilinta was safely switched to clopidogrel.
MR complained about muscles pains, which she attributed to low potassium and her water pill.
After a thorough medication reconciliation, the pharmacist determined that her muscle pains were actually due to an interaction between amlodipine 5 mg and simvastatin 40 mg.
After informing MR's doctor, simvastatin 40 mg was changed to rosuvastatin 5 mg. The successful switch resulted in the absence of subsequent muscle pain.
At GS's dedicated appointment with the pharmacist, she brought the following supplements to include in her medication list: Brain Essentials, calcium + vitamin D, Digestive Essentials, melatonin, probiotics, Vision 360, and vitamin B12.
During GS's medication review, the pharmacist noted GS's decreased kidney function. GS also stated the following complaints: potential ineffectiveness of duloxetine in helping her mood and frequent low blood sugar. Her daughter even mentioned recent potassium issues.
Upon additional research, the pharmacist counseled GS about a few precautions with most of her supplements but strongly recommended against Digestive Essentials. Not only can the Digestive Essentials components worsen kidney function, but all of GS's complaints can actually be attributed by this supplement.
MG was discharged from the hospital to the the nursing home on a Saturday. MG's doctor prescribed Xarelto to treat a blood clot that developed in her leg.
Unfortunately, MG's insurance wanted to hear from the doctor before covering for Xarelto. To make matters worse, the prior authorization process can potentially take 1 to 2 weeks!
Fortunately, the pharmacist discovered that MG's insurance will cover enoxaparin and warfarin.
After informing MG's doctor, Xarelto was changed to enoxaparin and warfarin with follow-up labs scheduled in a few days. Due to the successful coordination of care as MG transitioned from different healthcare settings, a potential hospital readmission was avoided.
As insurance switches from a fee-for-service to a quality-for-service model, not meeting insurance requirements or star ratings means increased financial penalties.
For pharmacies, completing personalized medication management (PMM) appointments is a star rating that usually requires additional attention to avoid negative effects on insurance reimbursement.
Therefore, a SWOT analysis was performed. Afterwards, the PMM process was streamlined and the marketing verbiage was changed.
Efforts proved to be fruitful; the end result was improved insurance reimbursement due to an increase in the completion rate from 33% to 100%.