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The Basics of Managed Care Pharmacy

Ellen Scharaga

· Medicine
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Ellen Scharaga has spent nearly six years with Alegria Specialty Pharmacy in the role of operational consultant. A pharmaceutical sciences graduate of St. John’s University, Ellen Scharaga spends time engaging with a number of professional groups and organizations, including the Academy of Managed Care Pharmacy.

The Academy of Managed Care Pharmacy (AMCP) functions as the nation’s leading professional society for pharmaceutical care practitioners serving in managed care pharmacy environments. Managed care pharmacy involves the development and implementation of best medication use practices, with an end goal of optimizing not only the health outcomes of patients, as well as society overall, but the health care resources necessary for these outcomes. Managed care practices are heavily guided by provable data and have the potential to influence the care of millions of individuals.

A wraparound system, managed care pharmacy systems involve manufacturers, distributors, retailers, pharmacy benefit managers, private and public health insurance providers, and, of course, patients. In a managed care pharmacy setting, pharmacists have a variety of responsibilities as they collaborate with other healthcare workers to meet a diverse range of population needs.

Common tools, meanwhile, range from clinical programs, such as drug utilization reviews and medication therapy management, to channel management resources. This approach can be used to address health concerns as diverse as disease prevention and access to quality care.