Human Resources: URAC announces first companies to earn new Pharmacy Benefit and Drug Therapy Management

Washington, D.C. Oct. 2, 2007 – URAC announced today that 10 organizations have successfully earned its Pharmacy Benefit Management Accreditation, the first voluntary accreditation developed for the industry. Four organizations have also earned URAC’s new accreditation for Drug Therapy Management, a range of pharmacy management services designed to optimize therapeutic outcomes for individual consumers.

Nearly 70 percent of Americans receive their prescription medications through pharmacy benefit management companies. URAC accreditation assures for consumers and purchasers that the organization is clinically focused and meets quality standards for consumer protection and empowerment. The Pharmacy Benefit Management Standards were developed by more than 30 members of a multi-disciplinary stakeholder committee over the course of more than a year. Initial standards underwent a public review and comment period, then field testing by a dozen pharmacy benefit management organizations representing 52 percent of the current lives covered under pharmacy benefit management programs across the nation.

The standards address organizational quality, customer service, communications, disclosure of pricing policies, pharmaceutical distribution, drug utilization management, and formulary/pharmacy and therapeutics committee.

URAC's Drug Therapy Management Accreditation standards, developed concurrently with the Pharmacy Benefit Management standards, are designed to help organizations drive appropriate therapeutic outcomes for consumers with a clear focus on patient safety, outcomes measurement and quality improvement. They address a broad range of functions, such as development of clinical policies using evidence-based medicine; patient communication regarding medication use; and promoting consumer rights, shared decision making and education.

“These companies voluntarily sought a rigorous evaluation of their operations and have earned the URAC seal of excellence,” said Alan P. Spielman, URAC’s president and chief executive officer. “The accreditation standards were developed by a team of experts who buy, pay for and manage pharmaceutical programs, along with those who prescribe, dispense, and use the medications. Accreditation is a validation that companies that obtain the URAC seal are committed to quality and are willing to be accountable throughout their operations.”

Pharmacy benefit management is a relatively new health care management segment, but has grown rapidly as more health care dollars are spent on prescription drugs. Confusion and controversy about how pharmacy benefit management

organizations achieve their cost and quality management objectives has drawn interest from state legislatures, regulators and the courts. Independent, third-party accreditation is valuable as it enables organizations to voluntarily demonstrate excellence. Additionally, URAC’s standard definitions and delineation of the key elements needed to operate an effective pharmacy management program will help to improve understanding among all key stakeholders.

URAC’s accreditation process for both Pharmacy Benefit Management and Drug Therapy Management includes an application and evaluation process, a rigorous on-site evaluation and assessment by a URAC accreditation team, and review and consideration for accreditation by URAC’s Accreditation Committee.

The companies achieving URAC Pharmacy Benefit Management Accreditation are:

Aetna, Inc.; Caremark Rx, LLC DBA CVS Caremark/Caremark; Envision Pharmaceutical Services, Inc. and Rx Options, Inc. d/b/a Envision Rx Options; Express Scripts, Inc.; Humana, Inc.; Medco Health Solutions, Inc.; Navitus Health Solutions, LLC; PerformRx; Prescription Solutions; and Prime Therapeutics, LLC.

The Companies that are In-Process for Pharmacy Benefit Management Accreditation are:

Catalyst Rx and US Script, Inc.

URAC’s Drug Therapy Management is applicable to a broader range of health management organizations--pharmacy benefit management companies, or care management companies with oversight of a clinical Drug Therapy Management program, such as case management or disease management organizations. The companies achieving URAC Drug Therapy Management Accreditation are:

Aetna, Inc.; Caremark Rx, LLC DBA CVS Caremark/Caremark; Catalyst Rx; and Prescription Solutions.

“These companies represent more than one-half of the commercial prescription benefit management marketplace,” Spielman said. “Accreditation means consumers can be assured that ongoing accountability and quality best practices will continue to be a major focus for these companies. We encourage all purchasers of pharmacy benefit management services to leverage the URAC quality standards by including URAC Pharmacy Benefit Management or Drug Therapy Management Accreditation as an essential requirement in their procurement and vendor management activities.”

For more information about Pharmacy Benefit Management and Drug Therapy Management Accreditation go to www.pbm.urac.org

About URAC

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit www.urac.org.