Proactive daily clinical reviews lead to significant savings and improved care

EmpiRx Health conducts daily reviews of claims over $2,400 for medical appropriateness and performs consultative phone calls to physicians to discuss patient therapy. This ensures each patient receives the right drug, the right dose, at the right quantity for the course of therapy to achieve the best possible health outcome at the lowest cost.

Identification

  • HP Acthar Gel was prescribed for 6 months for a Non-FDA approved indication of Focal Segmental Glomerulosclerosis (FSGS)

Proactive Consultation

  • Clinical team reviewed the case, determined the medication was not clinically appropriate due to lack of studies that proved efficacy
  • Our pharmacist spoke to the physician and provided treatment options that were recommended per literature review
  • Physician reviewed our findings and worked with the patient to maximize the 1st line therapy, treat potential adverse effects, and research alternative options
  • Our pharmacist provided a direct phone number to the physician allowing for an expedited review process if an alternative therapy was requested at a later date

Outcome

  • Physician agreed with our recommendation to switch from HP Acthar Gel ($815,000/year) to Mycophenolate ($6,500/year)

Evidence-based protocols and physician engagement improves patient health outcomes while reducing overall costs.

Contact us today for more information about EmpiRx Health, our Clinical Savings Guarantees, and to hear how we are changing the status quo in the Pharmacy Benefits industry.