Beyond Prior Authorization: Reframing Pharmacy Utilization Management as a Clinical Strategy

 By Reema Hammoud, Pharm.D, BCPS, Director, Clinical Strategy 

Pharmacy utilization management plays an important role in health plan operations, yet it's often treated as a back-end administrative task rather than the clinical and strategic discipline it can be. As drug costs rise and specialty therapies expand, health plans, payers, and PBMs have an opportunity to build programs that deliver greater clinical rigor and long-term value. This whitepaper, Reframing Pharmacy Utilization Management as a Clinical Strategy, explores what that looks like in practice.

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