• Formulary Management: Our national formulary encourages the use of lower-cost drugs, including generics, without compromising clinical effectiveness. By offering a multi-tier customized design, we can be as open or restrictive as you need.
• Customized Co-Pays: Our drug-specific co-pays and multi-tiered co-pays tie together drug effectiveness and cost, while still allowing member choice.
• Prior Authorization, Medical Necessity and Step Therapy Programs: We use rule-based programs to help reduce duplicative prescribing and usage and offer lower-cost therapies without sacrificing effectiveness.
• Deductibles and Benefit Maximums: We can show you how to use PBM tools to encourage responsible prescription usage by plan members to balance your need for cost savings with patient access.

• Online Drug Utilization Review (DUR): We designed a tool set to control utilization before, during and after drug dispensing. By identifying over-utilization, therapeutic duplication and excessive dosing, you can realize cost savings and limit unnecessary prescriptions.
• Refill Notification: When your plan members have chronic conditions, we can keep their treatment regimen on track by providing refill reminders.
• Specialty Pharmacy Integration: Specialty diseases account for a large percentage of drug expenditures. BioScrip is a leader in providing specialty medications, including infusion services, to treat complex chronic conditions. Our Specialty Mail Services help contain costs while improving patient outcomes.
  

Make sure your plan members have pharmacy access where and when they need it with our BioScrip Pharmacy Benefit Management Services. We provide a comprehensive pharmacy network for accurate claim processing and reporting.

• Network Design and Management: We offer nationwide access to local pharmacies in all major cities. More than a million plan members rely on our network of 60,000 pharmacy locations.
• Mail Service: Our wholly-owned, state-of-the-art mail service facility offer quick and accurate delivery of prescription medications via mail. Our Mail Services are tailored for 90-day maintenance medications to help control conditions such as asthma, high cholesterol, diabetes, and hypertension via home delivery.
• Claims Processing and Adjudication: We offer exact benefit implementation and execution with the flexibility to allow for all plan design options. Member coverage verification, formulary compliance, claims approvals, member co-pay and pharmacy reimbursement are all adjudicated in real time.
• Customizable Data Reporting: Utilization data is key to understanding the effectiveness of your PBM in executing your pharmacy benefit plan design. BioScrip Central, our Web-based reporting system, provides timely information and gives you the flexibility to find the data you need and report it in the format you want. Our experienced account management team is trained to help you define prescription management issues and customize a program to address any problems that may arise.

• Assess your current needs
• Gather supporting data
• Design and implement customized program
• Analyze program results

To find our how PBM can help you, contact:
PBMclients@bioscrip.com