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Utilization Management Approach
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Utilization Management Approach to Reducing Drug Spend

Promoting the safe and appropriate use of medications is an integral step in managing drug spend and utilization across all therapeutic categories. MaxorPlus integrates guideline-driven utilization management strategies to help mitigate unnecessary spend for our clients and improve member outcomes.

In addition to the below strategies regarding diabetes spend and opioid management, we use utilization management strategies to focus on reducing duplicative therapies for patients across both the traditional and specialty drug spaces. Our team of member advocates focus on creating meaningful connections with our members to improve both member outcomes and satisfaction. By directing members to clinically appropriate therapies, we are able to reduce the medication burden while lowering overall spend and promoting optimal quality of care.

Diabetes Spend Management

Diabetes spend continues to top the traditional drug landscape with high-cost GLP1 medications leading the way. In order to ensure these drugs are being used appropriately for Type 2 Diabetes Mellitus and not weight loss, MaxorPlus has incorporated utilization management strategies, which has led to savings for clients.

Safe Dispensing of Opioids

The Maxor Opioid Management program focuses on the safe prescribing of opioid medications and is a standard offering for all clients. Step-therapy requirements for opioids play an integral part in the safe dispensing of these medications. Clinical review of high-dose combinations and insurance of opioid-reversal agent access are all part of the comprehensive MaxorPlus approach.