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One of UPMC for Life's main goals when creating its drug formulary (the list of medications we cover) is to keep our members safe.
An important way we keep members safe is through our drug utilization review.
We have gathered data over the years, and that data now helps us recognize harmful drug-drug interactions. We have safeguards built right into our pharmacy system that reduce the chances of our members experiencing a harmful drug interaction.
UPMC for Life will send an electronic warning to your pharmacist if he or she tries to fill a prescription for a drug that could interact adversely with another medication that you are already taking. This service has been available to our members for some time, and it is constantly reviewed as new drugs come to market, or as new, potentially harmful drug combinations are discovered.
Drug utilization is also reviewed after prescriptions for medications have been filled. Our clinical pharmacy team reviews, reports, and identifies members who are at risk for adverse drug events. The team will contact the members' doctors to discuss potential problems uncovered during the review.
If you have more than one long-term health condition, take many medications every day, and have an expensive drug therapy regimen, you might feel like you could use some extra help managing your medications.
UPMC Health Plan’s Medication Therapy Management (MTM) program is available at no cost to you. The program is administered by a team of health care professionals that includes pharmacists, registered nurses, and social workers.
If you meet the criteria below, you are automatically enrolled in the program. You don’t have to do anything. You can disenroll at any time by calling our Pharmacy Clinical Operations Department at 1-866-778-6073 Monday through Friday between 8 a.m. and 4:30 p.m. TTY users should call 711. But the program is very helpful. It includes:
You must meet the following criteria to be eligible for UPMC for Life's MTM program.
2019 You must meet the following criteria to be eligible for UPMC for Life's MTM program.
If you are eligible, you will receive a letter that:
Members who do not respond to the letter will receive an automated phone call and/or a call from a pharmacist to schedule a CMR. Members in the MTM program may also receive phone calls from a registered nurse, social worker, and/or case manager.
This program is not considered a benefit. For more information regarding UPMC for Life's Medication Therapy Management program, please call our Pharmacy Clinical Operations Department at 1-866-778-6073 Monday through Friday between 8 a.m. and 4:30 p.m. TTY users should call 711.
UPMC Health Plan, Inc.