PSG - Pharmaceutical Strategies Group

Pharmacy Program Diagnostic (RxDiagnostic℠)

PSG’s clinical pharmacists are experts in designing and implementing programs to optimize the utilization of pharmaceuticals.  Our proprietary pharmacy program diagnostic solution, RxDiagnosticSM, assists clients in improving efficiencies, eliminating waste, improving compliance, and improving the utilization of low-cost alternatives.  Clients who have deployed our RxDiagnosticSM methodology have achieved savings of 5-15% of total pharmacy program costs.

A custom timeline for the RxDiagnosticSM evaluation process is developed for each client depending on the size and scope of the project. The resulting deliverable identifies key drivers of pharmacy program performance and gaps between current and desired/best-in-class performance levels.  The report focuses on the effectiveness of the program and identifies opportunities to improve the contractual, financial, clinical, and operational components of the current program performance. 

Optimal Contract Structure

The foundation for any successful pharmacy program is a best-in-class PBM agreement.  The RxDiagnosticSM process reviews each client’s current pharmacy program agreement to determine whether:

• Contract definitions are appropriate and clear.
• Contract pricing elements are best-in-class and represent the value of our client’s relationship with the PBM.
• Contract pricing elements and strategy have features that demonstrate long-term value and viability.
• Contract operational performance clauses are measurable.
• Performance penalties are meaningful in relation to the overall size of the contract.
• Audit rights are clearly described and are broad enough to validate all important pricing aspects of the contract.
• Termination rights are clear and appropriate.
• Other contract features specific to the client’s current program structure.

Clinical Savings Analysis

PSG has a team of eight clinical pharmacists that work to identify opportunities to improve the clinical performance of our client’s pharmacy programs.  The RxDiagnosticSM process also focuses on clinical opportunities for program improvement.  (e.g., specialty utilization).  We regularly complete analyses of our client’s program data to identify opportunities to:

• Optimize medication dosing.
• Improve patient compliance.
• Eliminate waste and improve efficiencies.
• Reduce or eliminate duplicate therapy.
• Improve utilization of cost-effective drugs and distribution channels.
• Improve effective use of specialty medications.

Formulary Analysis

PBM formulary strategy has a material impact on employee satisfaction and overall costs in pharmacy programs.  Our clinical pharmacists and financial analysts are adept at conducting analyses to evaluate the effectiveness of PBM formularies.  The end result is a cost effectiveness assessment of a PBM’s formulary approach, coupled with detailed recommendations for how to improve any shortcomings of the program. The RxDiagnosticSM process identifies ways to drive utilization toward more cost-effective medications through better product selection (e.g., generics, OTCs, therapeutic alternatives) and channel delivery (e.g., mail order, chains).