By: Christian Tadrus, Pharm.D., R.Ph.
This issue of data-mining dispensing data in order to influence prescriber and customer behavior should be on the radar of every pharmacist, pharmaceutical provider and pharmacy organization in the country as the practice brings up a whole host of issues not the least of which is pushing for inappropriate therapeutic switches.
There is also evidence that some PBMs are using this data mining technique to identify expensive specialty and even often inexpensive maintenance medications from claims data and then contacting patients directly with letters suggesting that they begin ordering these medications directly from the PBM-owned mail-order houses often enticing the customer with a very specific cost savings offer if they switch.
Considering that all PBMs such as CVS Caremark require pharmacies to provide patient-specific information in order to pay a claim, this practice might be equated to forcing pharmacists to provide the bullets for the gun with which they will soon be shot.
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Christian Tadrus, Pharm.D., R.Ph.