Medical Pharmacy Solutions
What is our medical pharmacy solution?
When we say “medical pharmacy” we’re talking about specialty drugs that are administered by healthcare professionals and billed on the medical benefit. We deliver targeted and timely initiatives for medical pharmacy management, and innovate new solutions to take on the latest developments in our industry.
What do you get when you partner with Magellan Rx?
- True coordination across all sites of service to optimize appropriate use, member adherence, and cost-effectiveness
- Future-focused strategies for new and emerging therapies and top spend categories
- Access to extensive clinical expertise and experience with a dedicated medical pharmacy team backed by an Expert Clinical Network of over 175 key opinion leaders
- A deep understanding of pharmacy trends, including a decade as the industry’s only resource for medical pharmacy trends, pipeline activity, and management strategies
Our suite of solutions:
We manage medical pharmacy drugs with the same rigor as traditional pharmacy benefit drugs by leveraging a suite of solutions that can provide up to 20% overall savings.
Prior authorization
Ensures complex and high-cost drugs are prescribed according to evidence-based policies
Post-service pre-payment claim edits
Assures medical benefit drugs are paid correctly
Provider network strategy
Encourages lower cost but equally effective agents through a variable fee schedule
Site of service management
Guides medical injectable drug administration to the lowest cost and clinically appropriate site of care
Medical formulary management
Enhances management of medical drug classes to promote the most cost-effective therapies
Custom disease-specific conditions
Solutions built to address some of the most complex and high-cost conditions that impact rising medical benefit spend
– Oncology
– Autoimmune
– Immune Globulin
– Retinal Disease
– Hemophilia
– Rare Disease
Who can use our medical pharmacy solutions?
Please note that individual program implementation is dependent on plan size and other factors. We will partner with you to create the custom solution that best meets the needs of your unique population.
- Employer Groups, TPAs, Unions (select programs only)
- Government
- Health Plans
These flexible solutions can also operate outside of the traditional payer-PBM relationship. Now, health plans can plug in to the extensive clinical expertise and experience at Magellan Rx by delegating specialty and medical drug management services while retaining a separate pharmacy benefit manager.
Want to learn more about our medical pharmacy solutions?
Reach out to our team to learn more; we’d love to hear from you.