Behavioral Pharmacy Management

In 2002, recognizing the tremendous increases in utilization of medication to treat behavioral illness, CNS developed the Behavioral Pharmacy Management (BPM) process to support the quality of this expanding prescribing. In applying the methodological rigor of CNS’ Expert Consensus Guidelines with IT-enabled algorithms (Quality Indicators™) to retrospectively screen large pharmacy claims databases, CNS identifies physicians who may be in need re-alignment with evolving best practices in the prescribing of over 400 different psychotropic medications.

Interventions with physician prescribers are consultative and educational, aiming to impart knowledge of best practices. By sensitively intervening with Clinical Considerations™ based on literature evidence or recognized expert opinion, providers are given clear, simple suggestions for improving the quality of treatment. BPM acts as an information service and does not engage in the practice of medicine or other clinical activity. Information provided is evaluated by medical or other healthcare professionals in the exercise of their professional judgment. With BPM, no additions are made to the existing treatment team; rather, the team is supplied with succinct information at the right time with education around the best practice. BPM continues to analyze prescriber data monthly during the contract period to further refine and measure the effect of the intervention. Here, BPM provides for continuous monitoring over time, escalating the level of intervention as needed, including peer-to-peer physician contact.

BPM highlights include:

Continuous pharmacy surveillance to apply Quality Indicators™ and provide Clinical Considerations™ to physicians outside best practices
Growing portfolio of over 80 child, adult, and elderly Quality Indicators™
Sensitive, evidence-based interventions that include patient specific and best practice information regularly receive positive physician feedback
Prescriber alert communications, summarizing case demographics, 90-day pharmacy history, and a listing of all psychotropic prescribers, critical for physicians and health plans to review patient progress
Change reports to notify clients of the evolving status of identified patients and physicians
No requirements regarding the special collection of data
Data warehousing and processing which is fully certified and HIPAA compliant

BPM has enabled clients to recognize savings in behavioral pharmacy costs as a result of prescriber education and outlier management strategies. Recent studies have demonstrated that in addition to prescription drug savings, inpatient and outpatient costs are reduced for those patients whose physicians align their prescribing with best practices.