Behavioral Pharmacy Management
The Behavioral Pharmacy Management program (BPM) is offered by Comprehensive NeuroScience Inc. (CNS), an independent vendor who contracts directly with state Medicaid departments or other payers. Lilly provides financial support for the initiative, while the operation and implementation of the program is done solely by the state and CNS.
The state and CNS work together to evaluate all mental health medication pharmacy claims and identify prescribing patterns that are inconsistent with national, evidence-based guidelines. Some of the inconsistent prescribing patterns seen in reports about the BPM include:
- Failure of patients to fill prescriptions in a timely manner
- Duplicative prescribing of medication by different doctors for the same patient
- Premature, rapid switching from one medication to another
- Prescribing multiple medications from the same therapeutic class
- Prescribing above or below recommended dosing levels
The BPM, which has been implemented in over half of the states, sends educational materials to doctors who deviate from national prescribing guidelines, and also informs doctors when their patients fail to fill prescriptions in a timely fashion. Physicians who continue to experience the same issues over time are offered a peer consultation to discuss prescribing practices.
Read about the BPMs in place in Missouri, Utah, Oklahoma, Michigan and New Jersey.
