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Real-time analysis is performed on all submitted claims to detect duplicates, refills too soon, and excessive dose or length of therapy.

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Opioid prescribing patterns, dispensing patterns of pharmacies, and member utilization are retrospectively reviewed to identify at-risk members.

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Formularies are designed to promote clinically appropriate drug use and generic utilization to offer the best value from a clinical, cost, and member-satisfaction perspective.

Analysis PDMP

Our pharmacists use a national prescription drug monitoring database to evaluate each prescription in the context of a member’s entire therapy, including prescriptions they’ve received from other pharmacies.


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Limits are enforced in alignment with CDC guidelines on the days’ supply, number of units, and refills of opioids that members can receive within a given time period.

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Before benefit coverage is approved, the medical necessity of using opioids is confirmed to ensure they’re used in the most appropriate cases and dosages as recommended by the FDA.

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Opioid costs are kept at bay by requiring members to try preferred drugs before more costly alternatives are covered.

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Appropriate cost control and care management strategies are developed with guidance from the FDA to prevent fraud, waste, and abuse.


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Our website provides detailed information on how members can dispose of their unwanted medication, and we ship DisposeRx with each order containing an opioid.

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Clients are provided with useful, detailed reports on opioid usage within their membership, as well as progress on their participation with the program.

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Educational content and resources, including presentations and articles, are available for clients to share with their members.