Initial Therapy Protocol
For clients that have elected to use the Select 90 Rx network, MaxCare
has developed an innovative tool called Initial Therapy Protocol.
Goal
The goal of initial therapy protocol is to avoid waste of very costly
medications, while providing patient convenience on established
medication therapies.
Rationale
It is difficult for the doctor and pharmacist to predict whether the
patient will tolerate a medication or if the strength of the
medication will be sufficient to treat the patient’s condition without
causing side-effects. During these initial days of therapy, the
patient’s first prescription is limited to a month supply until it is
known whether the drug and regiment will meet each patient’s specific
needs. Once it has been established that the medication works and is
well tolerated, patients may receive up to a 102 day supply (certain
plans use 90 day increments instead) of medication provided they
continue to refill their medication timely and as prescribed by their
doctor.
Initial Therapy Criteria
Initial Therapy of no more than a 34 days supply (certain plans use
30-day increments instead) within 120-day period is required before
quantities are allowed beyond a 34-day supply for beginning therapies,
which might not be tolerated and are discontinued or in instances when
the drug strength is changed.
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