Clinical Services Team: Pharmacy Unit

% of Medicaid providers’ prescriptions that have preferred status on the preferred drug list (PDL)

95.1%Q2 2020

Line Bar
Notes on Methodology

The target for this measure is 97.0%.

Partners
  • Medicaid Providers
  • Change Healthcare
Story Behind the Curve

DVHA’s Preferred Drug List (PDL) includes a list of preferred and non-preferred drugs.  

The PDL is designed to manage the state’s cost of providing prescription drugs while assuring broad access to clinically appropriate and cost-effective therapy. Both clinical and cost considerations determine PDL placement.

Measuring how often providers are prescribing a preferred medication versus a non-preferred medication that requires a Prior Authorization (PA), allows DVHA to target and educate low compliance prescribers to improve compliance rates and lower DVHA’s net costs.  

Last updated:  07/15/2020

Strategy
  • Most preferred drugs do not require PA where non-preferred drugs do require a PA. Using a preferred drug lowers provider administrative burden and lowers DVHA’s net cost for drugs.
  • Changes to the PDL are posted on the DVHA website
  • Communication is sent to providers about changes
  • Providers have access to the Provider Portal
  • The Pharmacy Unit continues to strategize about how to improve compliance
Action Plan
Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy