Pharmacy Case Management Services

The clinical and economic consequences of poorly managed drug therapy are staggering. Most drug-induced complications are avoidable or can be corrected....but not necessarily by the traditional U.S. healthcare model.

Covington Healthcare Associates (CHA) can help you better manage your high-cost pharmacy cases. Drug Utilization Reviews (DURs) in the context of our Pharmacy Case Management Program can provide your company with significant cost savings. Our evidence-based DURs are considered best-in-class DURs because our clinical pharmacy staff has the unique ability to blend clinical and economic considerations. The results speak for themselves. Consider the cost savings achieved from the CHA Pharmacy Case Management Program…

A Third Party Administrator (TPA) enrolled 35 patients into the program. Their return on investment (ROI) was very significant as they realized an annual savings of $3,708/patient/year (see chart below). Due to the success of the program, the TPA has now enrolled over 150 patients.

Savings

Average Savings Per Patient Per Year

$3,708

Realized Savings at 2 Years for 35 Patients

$259,561

Potential Savings After 5 Years for 35 Patients

$648,902

Potential Savings After 10 Years for 35 Patients

$1,297,805

DURs can also provide you with significant cost savings when conducting Medicare Set Asides (MSAs). Consider the cost savings achieved in actual settlements involving five representative cases:

Example

Lifetime Pharmacy Cost Before the DUR

Lifetime Pharmacy Cost After DUR

Savings

Case #1

$152,193.22

$1,945.52

$150,247.70

Case #2

$84,689.54

$30,333.30

$54,356.24

Case #3

$121,434.00

$23,327.00

$98,107.00

Case #4

$229,416.49

$192,583.69

$36,832.80

Case #5

$48,361.00

$28,467.00

$19,894.00

Total Savings =

$359,437.74

Satisfied Clients...

"Covington's experience and proactive style has saved our clients thousands of dollars in unnecessary pharmaceutical expenditures." Tom Roper, J.D., President - Millennium Risk Managers

"My customers are extremely satisfied with Covington's work. Their DURs are the BEST I have ever seen. My most recent case saved my client $113,000 in future prescription costs." Karen Cofield, R.N., CEO - KRS-MSA

 

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