Trend Analysis
Araya’s clinical team will monitor your utilization trends to identify cost driver and clinical trends. Client reviews will include an analysis of your use.
Formulary Management
Pharmaceutical manufacturers represent one of the largest, most profitable and innovative industries in the world. In addition to using these resources to develop new drugs, they are also used to market and create demand for their products. The direct to consumer marketing, physician sales force and lobbying efforts of these organizations are one of the primary drivers of pharmacy cost increases.
While many new drugs represent improved clinical efficacy and better outcomes, others are simply copycats or marginally improved versions of legacy therapies. Araya’s clinical team continually reviews new products and helps our clients determine which truly offer additional benefits for your members and which ones are hype.
Therapy Management
The goal of therapy management should be to reduce the variation from the standard of care. Araya follows peer-reviewed and expert-panel endorsed guidelines when creating therapy management recommendations. We then take advantage of the very effective utilization management tools at our disposal to improve the population’s adherence to the recommended therapy.
Reducing variation from the standard = Quality
Care = Cost Effective Care
Care = Cost Effective Care
Prior Authorization
Not every treatment regimen can or should be evaluated with a simple algorithm. When there is potential for adverse outcomes, high cost or unnecessary utilization it is important to review the chosen treatment on a case-by-case basis. Araya proactively manages these medications via an alert system. We do not wait for an inquiry from the patient, pharmacy or prescriber. When the medications present in the alert queue, they’re routed to clinical for review and the pharmacy is contacted with the decision.
Compliance/Persistence
The right therapy needs to be complete and consistent. Araya’s compliance and persistence program identifies gaps in care and notifies prescribers of patients who are not following directions or could benefit from addition or discontinuation of other medications.
Wellness Programs
Araya has a number of programs to help improve the overall wellness of your covered populations, including options such as vaccination schedule reminders and flags for medications that increase the risk of fall.
