People caring for your people

MC21 Colombia develops and implements an integrated management model to promote the best use of out patient medication, and gives support to health insurance companies and other entities responsible for the supply and payment of out patient medication.

Programs and Services – logoMC21-para-titulos

Clinical

Pharmacy and Therapeutic Committee Management

The client will receive the support of the MC21 Colombia specialized clinical team. The team will follow-up on medication, based on the users utilization trends.

There will be a Pharmacy and Therapeutic Committee, which is an independent panel of specialized physicians and experienced clinical pharmacists that will perform the following tasks, among others:

  • Medication evaluation based on the findings of inadequate use in the retrospective and prospective medication utilization analyses.
  • Analyses of clinical alerts based on findings and identified client´s needs.
  • A client quarterly report with recommendations for adequate medication use.
Clinical Programs Development

Development and management of clinical tools designed to intervene in the patients´ health results by assuring the quality of medical care and prescription patterns.

The following are among those programs:

  • Step Therapy: A program that allows the prescriber to treat his/her patients with a first tier medication before proceeding to treatment with a second or third tier drug.
  • Criteria for Drug Authorization: The specific and predetermined physiological, clinical and/or pharmacological requirements that a patient must meet in order to receive certain medication. This program applies to strictly controlled drugs, as they may significantly impact the patient´s safety and /or the pharmaceutical expense.
  • Pharmacy therapy guidelines: Its purpose is to facilitate the election of drug at prescription, providing therapeutic alternatives with maximum effectiveness, safety and efficiency, according to the patient´s condition. These guidelines are developed for pathologies of high prevalence and/or elevated cost.

The Pharmacy and Therapy  Committee participates in the design, evaluation and approval of these programs, based on an exhaustive revision of medical and pharmacological literature, and the clinical experience.

Develop and operate clinical alerts on line

MC21 Colombia supports physicians on a continued basis during the process of prescribing and identifying the risks in the use of medication, in order to offer patients the pharmacological therapy that will maximize their safety through the use of on line clinical alerts. For example:

LOSARTAN – ENALAPRIL (High risk pharmacological interaction)

Risk: The concurrent use of these two medications may produce hyperkalemia (elevated level of potassium serum), with possible cardiovascular complications, such as arrhythmia.

Recommendation: If possible, avoid the concurrent use of these two medications or periodically check the patient´s levels of potassium serum.

At present, we have an operational clinical alert data base that signals:

  • Pharmacological Interactions:  To be avoided, High Risk or Moderate Risk
  • Maximum Dosage
  • Duplicated Therapy
  • Interaction Medication/ Age
  • Interaction  Medication/ Illness or Condition
  • Interaction  Medication/ Pregnancy
  • Interaction Medication/ Fitotherapeutic
  • Allergic Reaction to Medication

The alerts are constantly monitored, reviewed and updated by MC 21´s clinical team.

 

Medication Utilization Retrospective Analyses (AUM)

MC21 Colombia will submit reports to its clients on Medication Utilization Retrospective Analyses. These reports will include analyses of the clinical alerts, prescription patterns and any finding of inadequate use of medication, along with scientific and technical recommendations to improve medication utilization. Said analyses will be retrospective and prospective.

The objective of the service is to improve the quality of the physician´s prescription patterns and devise ways to optimize costs.

Physicians' Education Program
  • Related to the sharing of the information on Medical Utilization Analyses in the regions with the group of primary care physicians and pharmacists.
  • Development of educational materials for the web
  • Development of specific high impact alerts on the physician´s screen as the prescription module is uploaded.
  • Individualized academic visits.
Pre-authorization Center
  • Operation from MC-21 Colombia of the clinical protocols for the client
  • Protocol compliance monitoring by MC-21 Colombia
  • Report of the results of the clinical protocol application
Medication Information Center

Gives answer to the worries and doubts about drug related information to physicians and the internal client clinical team.

Cost Optimization Strategies

MC21 Colombia develops cost optimization strategies in order to support more cost effective treatments and prevent resource wastefulness. These strategies are put in place with the client´s approval.

Some of these strategies are:

  • Preferred Drug Lists (LMP): For pathologies with high cost impact, to assure users the availability of a wide range of therapies. In cases where therapeutic bio-equivalent drugs are available, the most cost effective options will be considered from a clinical standpoint.
  • Mandatory Generic: Based on findings for problems in the use of brand medication, the use of a generic alternative with therapeutic bio-equivalence and more cost effectiveness will be promoted.
  • Supply Days Strategy: For high cost drugs used in acute pathologies, preventing wastefulness in the prescription of medication such as inhalers, topical medication, eye and ear drops and oral liquids.
  • Maximum Number of Drugs Refills Strategy: For repeated or chronic use of medication, when management guidelines suggest short-term or limited use.
Periodic Alerts Reports

MC 21 Colombia provides periodic reports on the clinical alerts to the users or auditors designated by the client, for their analysis and intervention when required.

The reports may be sent through e-mail or FTP for direct access by the persons designated by the client.

Monthly reports will be provided on the actual and potential savings estimates generated by the clinical alerts, and will include recommendations for an adequate use of medication and prevented adverse events.

Operational

Quality Control Program

Strategies geared to assuring the control of risks associated to the use of medication from the perspective of drug quality, safety and effectiveness, such as medication errors and specialized medication monitoring, among other.

Business Intelligence Platform

These reports are personalized and designed according to client´s needs.

ejemplo plataforma inteligencia de negocios
Example

Clinical Team Alerts Support Center (CAAEC)

MC21 Colombia will provide support and information to physicians and to the client´s internal clinical team on the clinical alerts generated in the prescription systems with the objective of clearing doubts and worries about the clinical alerts produced by the Medication Utilization Analyses (AUM) and/ or the reports on the business intelligence platform. This service is supported by a team of specialized pharmacology physicians,epidemiologists, clinical pharmacists and chemists.

MC21 Colombia has the medical and pharmacological data bases (Micromedex, JAMA, Pharmacology-Epidemiology Drug and Safety, American Journal of Health System Pharmacy, Drugs, among other), and the clinical experience to clear doubts and worries about alerts generated in the formulation process.

Physicians and the client´s clinical team will be able to contact our toll free support center.

Clinical alerts at prescription and transcription

Through is technological platform, MC-21 Colombia processes on line transactions of the physician´s prescribed formulas in real time, at the time of prescription.

The processing of on line transactions provides clinical alerts that lessen the incidence of medication errors and other medication related problems.

This process is conducted in accordance to the parameters of the pharmacy benefits plan and the medical criteria established with the client.

During this process, the physician continues to use the assistance application and the clinical history of his local IPS. The prescribing physicians will be connected on line with MC-21 Colombia´s technological platform.

Clinical alert registry for retrospective analysis

In addition to the on screen alerts at prescription and the generation of alerts at dispensing, MC21 Colombia will process and register on line the clinical alerts that are generated at the transcription systems in order to produce their retrospective analyses. In the dispensing process, alerts of the formulations for primary care medication that are directly dispensed at pharmacies will be captured and generated to assure that all alerts for the total treatment of any given patient are generated.

Clinical alerts shown on the dispensation screen

Through its technological platform, MC21 Colombia will register the clinical alerts generated by the client service systems, for the handwritten or printed formulations that are directly registered at the pharmacies. Only those alerts which are defined as presenting a potential health risk for the user will be shown on screen.

Once the alerts are shown on screen at dispensing, they are immediately notified to the client´s auditing team for their management.

We support the best use of medication, in order to improve the quality of patient´s care in the prescription and dispensation of out patient medication.

Strengths – logoMC21-para-titulos
1

Accesibility

Immediate and on -line information to help make decisions

2

Flexibility

Support health professionals with scientific evidence to improve medication management

3

Adaptability

Integration of medical services to the pharmacy benefit management system

4

Innovation

Provide savings while improving the quality of the patients health care

Do you know the advantages of having a Pharmacy Benefits Manager?
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