DUR programs or Drug Utilization Review programs are structured, authorized, and ongoing reviews of plan members’ medication use, dispensing pharmacists, and prescribing doctors. These are focused on comprehensive reviews of members’ medication and prescription data before, during, and after given medications to ensure positive patient results. DUR programs come in three types:
• Prospective: Review of a member’s drug therapy prior to dispensing medication.
• Concurrent: Continuing monitoring of the patient’s drug therapy.
• Retrospective: Evaluation of a patient’s drug therapy after receiving medication.
The Importance DUR Programs
Drug Utilization Reviews are crucial in helping plan sponsors, PBMs, and PBM consulting partners understand, decipher, and improve prescription, administration, and medication use. Plan sponsors will find these programs extremely useful since the results will be used to promote more efficient utilization of their resources. Pharmacists have an important role in these programs because of their expertise in pharmaceutical care.
DUR programs provide pharmacists the chance to determine prescription trends within different member groups including patients with high blood pressure, diabetes, ulcer, or asthma. Pharmacists must then collaborate with the plan sponsor, PBM, and PBM consulting partners to create an action plan for improving drug therapy. Essentially, Drug Utilization Review programs can effectively improve the quality of care, improve therapeutic results, and lower inappropriate pharmacy benefit costs.
What Else Can DUR Programs Offer?
While DUR programs significantly help PBMs and plan sponsors to manage drug use of plan members, doctors can likewise benefit from them when prescribing medication to plan members. The DUR results can be used by doctors to determine and monitor their own prescription behaviors that can be compared with widely accepted practice standards, along with pre-determined criteria, established by renowned medical national organizations.
Results of DUR programs can likewise be used by doctors for comparing themselves among other doctors regarding their treatment of particular diseases. These comparisons will be very useful in encouraging doctors to improve or modify their existing prescribing practices to hopefully deliver better quality of care. In addition, DUR programs can help PBMs and plan sponsors in developing educational programs that can be used for improving prescription, and patient and formulary compliance.