Opioid safety: Doing the right thing – a patient success story.
Subsys is a Fentanyl sublingual spray used to treat breakthrough cancer pain — approved only for cancer patients on round-the-clock opioids. When our Prior Authorization (PA) team received a request marked, “URGENT – Cancer Pain – Patient Almost out of Medication,” it was approved for a one-time, 30-day fill with chart notes requested. Eight days later, the same type of request was received again, but with an increased dose. Cost of the medication was more than $18,000 for eight days.
CastiaRx pharmacy audits uncover $1+ million in savings for clients in 2018.
To ensure prescriptions are processed correctly and you pay for legitimate pharmacy claims, CastiaRx conducts regular pharmacy audits and reviews. Most findings involve simple errors, but those errors can add up to significant dollar amounts. “In 2018, we audited more than 1,200 commercial pharmacies, resulting in over $1,100,000 in plan savings for our clients,” says Christos Ioannou, VP of Industry Relations.