RxBenefits Innovation 2023

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High Dollar Claim Review with Complex Condition Intervention Cuts Plan Costs by 18%

Without adequate utilization management, off-label prescriptions can be devastating to a pharmacy benefits plan’s spend if they make it on the formulary. When medications are used for non-FDA-approved reasons, self-insured employers run the risk of overpaying for expensive, unnecessary drugs that present potentially dangerous health outcomes for their members.

See how our team’s peer-to-peer review found two prescriptions being used for non-FDA reasons that were driving 18% of a client’s plan spend.

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