The rapid availability of pharmaceutical claims data tied to its electronic, real-time submission by network pharmacies demands that data analytics should be a key function of an effective pharmacy benefit management program. Trends in pharmaceutical utilization can be spotted quickly and may serve as a guide to the development of effective clinical strategies to maximize the value of pharmacy benefits to our members.
The ITIO has access to an integrated claims database that allows the use of analytic methods that can combine medical and pharmacy data as well as laboratory test results to look for the best overall solutions to possible health care problems and issues. The ITIO works with numerous other health care and policy experts at OSU and other state universities to identify possible therapeutic opportunities and discuss approaches to clinical analyses that could positively impact health care outcomes. The academic setting in which the ITIO operates assures that its work is unbiased and draws upon the most up-to-date research techniques.
RxOC staff has worked with ITIO representatives to look at numerous therapeutic areas over the last two years. One focus has been the application of medical claims information to help analyze where off-label use of pharmaceuticals may be driving cost increases tied to inappropriate use. Another area of concentration going forward will be the use of integrated data to develop strategies to manage costly specialty medications.
The above examples are just a couple of specific areas where the integration of data elements from multiple platforms can provide a great deal more insight than an analysis that only includes data from pharmacy claims. Over time, the RxOC’s business platform incorporating elements from the academic, public and private sectors will result in a unique partnership that intends to be at the forefront of health care outcomes research.