MHS CHRONIC MEDICATION AUTHORISATION PROGRAMME
OFFERED BY INSIGHT MEDICINE MANAGEMENT, A MEMBER OF THE MHS GROUP

DEFINITION
Chronic medicines represent the largest portion of medicine costs incurred by medical schemes. This programme manages and administers the medicine benefit of medical schemes. The objective is to achieve evidence-based, patient-specific drug treatment PLANS at an affordable cost.

The programme is a pre-authorisation system which ensures that a patient's prescribed medication treatment plan for their chronic illnesses is proactively and prospectively agreed with the prescriber prior to reimbursement. Since the choice of a medication treatment plan is unquestionably determined by patient-specific factors, the programme is patient-centric. This approach is an advance over the earlier drug-centric approaches (e.g. formularies or drug lists).

• Establishes a database of chronic patients and records their medicine usage,

• Pre-authorises medication treatment PLANS which are rational, cost-effective and affordable,

• Proactive, ongoing review of enrolled patients' plans, in line with clinical advances and changing drug costs,

• Clinical pharmacists negotiate with both doctors and patients in agreeing the patient-specific treatment plan.

• Interventions are based on current Best Practice treatment guidelines and Evidence-Based Medicine and are supported by internationally published scientific literature.

• Offers a toll-free answering service for patient queries and for enrollment into the programme,

• System-generated management reports to indicate uptake, trends, condition treatment costs, etc.

• Significant and immediate cost savings to the medical scheme on the medicine benefit,

• Additional cost savings to the medical scheme owing to optimising care - fewer hospitalisations, fewer emergency- and unscheduled doctor visits,

• Long term cost savings owing to improved drug care,

• Identifies and prevents drug therapy problems,

• Improves patient care by promoting Best Practice,

• Improves prescribing patterns,

• Improved health outcomes,

• Essential to, and integrated with, Disease Management programmes,

• Patient education and professional counselling over the phone ensures patient involvement and compliance,

• Proactive review of patient medication continually monitors patients' therapy to ensure that the medicine use remains cost-effective and in accordance with evolving Best Practice treatment guidelines,

• Direct, personal communication with the prescriber has a greater influence on prescribing and medicine usage than mailing and educational feedback.