Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
METHOD, APPARATUS AND COMPUTER PROGRAM PRODUCT FOR
IDENTIFYING POTENTIAL DRUG MISUSE
TECHNOLOGICAL FIELD
[0001] An example embodiment relates generally to a system, method,
apparatus and
computer program product for identifying potential prescription drug misuse
and, more
particularly, to the evaluation of prescription drug claims transactions of a
patient to identify
potential prescription drug misuse.
BACKGROUND
[0002] Prescription drug misuse has increasingly become an issue.
Prescription drug misuse
may take the form of a patient obtaining and taking more prescription drugs
than recommended
by a healthcare provider or by a patient obtaining more prescription drugs
than the patient
requires and then further distributing or selling the additional prescription
drugs to other people
in an unauthorized and unregulated manner. While prescription drug misuse is
disfavored for all
classes of prescription drugs, prescription drug misuse of opioids is a
particular concern, both
because of the addictive nature of opioids and the sometimes severe
consequences associated
with a patient taking more opioids than recommended by a healthcare provider
or by opioids
being taken by people to whom the opioids were not prescribed due to the
unauthorized
distribution of the opioids by the patient to the other people.
[0003] Access to prescription drugs is regulated to some degree by the
requirement that a
patient must be prescribed the prescription drug by a healthcare provider and
that the resulting
prescription must be filled by a licensed pharmacy. In some instances,
however, patients may
obtain prescriptions for an excessive amount of prescription drugs, such as by
obtaining
prescriptions for the prescription drug from a number of different healthcare
providers that in the
aggregate amount to an excessive amount of the prescription drug or by
obtaining false or forged
prescriptions for the prescription drug.
[0004] In an instance in which a patient obtains prescriptions for an
excessive amount of a
prescription drug, presentment by the patient of all of the prescriptions to a
single pharmacy may
result in the pharmacy identifying that the prescriptions in the aggregate
amount to an excessive
amount of the prescription drug and the pharmacy may only partially fill the
prescriptions such
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that the patient is limited to the maximum amount of the prescription drug
that the patient is
authorized to obtain. However, a patient may present different ones of the
prescriptions to
different pharmacies such that no one pharmacy is asked to fill prescriptions
for more of the
prescription drugs than the patient is authorized to receive. In some
jurisdictions, the pharmacies
operate relatively independently in relation to the fulfillment of
prescriptions. Moreover,
prescriptions are filled in at least some situations in a relatively real-time
manner, thereby
making it challenging to process manually, particularly in light of the number
of prescriptions
filled at a myriad of pharmacies every day. Thus, in these jurisdictions in
which the pharmacies
operate relatively independently, the patient may be capable of obtaining an
excessive amount of
prescription drugs including an excessive amount of opioids from the plurality
of pharmacies
even though no one pharmacy provided an unauthorized quantity of prescription
drugs.
BRIEF SUMMARY
[0005] A system, method, apparatus and computer program product are
provided in
accordance with an example embodiment in order to identify potential
prescription drug misuse.
The method, apparatus and computer program product of an example embodiment
evaluate the
prescriptions of the patient that have been filled at any of one or more
pharmacies to identify
whether those prescriptions of the patient satisfy criteria indicative of
potential prescription drug
misuse. Thus, potential prescription drug misuse is identified even in
instances in which a
patient presents prescriptions for fulfillment at a variety of different
pharmacies and even in an
instance in which the prescriptions of the patient filled at any one
particular pharmacy are within
the authorized limits and do not satisfy the criteria indicative of potential
prescription drug
misuse. In an instance in which potential prescription drug misuse is
identified, a notification,
such as an alert, may be provided, such as to the pharmacy and/or the
healthcare provider
prescribing the prescription drug, such that appropriate intervention with the
patient may be
instituted prior to filling the prescription.
[0006] The system, method, apparatus and computer program product provide a
number of
technical advantages. For example, although all prescription drugs could be
monitored for
potential misuse, the method, apparatus and computer program product of an
example
embodiment provide a technical advantage by being tailored to only monitor a
subset of
prescription drugs for potential misuse, such as the subset of prescription
drugs that are
addictive, that may cause the most deleterious effects if taken in an
unregulated manner or the
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like. In this example embodiment, the method, apparatus and computer program
product do not
merely create and store a prescription drug record for a prescription drug
that is included within
the subset of prescription drugs to be monitored for potential misuse, but,
instead, provide an
additional technical advantage by creating a prescription drug record and/or
storing the resulting
prescription drug record within a database in such a manner that the
prescription drug record for
the prescription drug that is included in the subset of prescription drugs to
be monitored for
potential misuse is distinguishable and identifiable relative to the
prescription drug records
created and stored for prescription drugs that are not included in the subset
of prescription drugs
to be monitored for potential misuse.
[0006a] In one embodiment, there is provided a system configured to process
prescription
drug claims transactions from a plurality of pharmacy computers operative in a
network to
identify potential prescription drug misuse, the system comprising: a database
of prescription
drug claims transactions; and a service provider computing device of a claims
processor
configured to process prescription drug claims transactions or a service
provider that edits the
prescription drug claims transactions prior to providing the prescription drug
claims transactions
to the claims processor, the service provider computing device comprising: a
communication
interface configured to receive data relating to a plurality of prescription
drug claims transactions
from pharmacy computers of a plurality of pharmacies that operate
independently in relation to
fulfillment of prescriptions such that the service provider computing device
is in common for the
plurality of independently operating pharmacies, wherein the data that is
received relates to
prescription drug claims transactions that comprise a prescription claim
request, a medical claim
request or a predetermination of benefits request; and processing circuitry
configured to: parse
the data to identify a patient and a prescription drug from a respective
prescription drug claims
transaction of the plurality of prescription drug claims transactions;
determine whether the
prescription drug is included in a subset of prescription drugs to be
monitored for potential
misuse; and only in an instance in which the prescription drug is included in
the subset, monitor
for potential misuse by formulating a search query for the database of
prescription drug claims
transactions based upon the patient and the prescription drug identified from
the respective
prescription drug claims transaction and determine by reference to the
database of prescription
drug claims transactions whether prescriptions of the patient related to the
prescription drug that
have been filled at any of one or more pharmacies satisfy criteria indicative
of potential
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prescription drug misuse, wherein the communication interface is configured,
in response to a
determination by the processing circuitry that the criteria indicative of the
potential prescription
drug misuse is satisfied, to cause a notification to be provided to a pharmacy
that submitted the
respective prescription drug claims transaction.
[000613] In another embodiment, there is provided a method implemented by a
service
provider computing device that is configured for processing prescription drug
claims transactions
from a plurality of pharmacy computers operative in a network to identify
potential prescription
drug misuse, wherein the service provider computing device is of a claims
processor configured
to process the prescription drug claims transactions or a service provider
that edits the
prescription drug claims transactions prior to providing the prescription drug
claims transactions
to the claims processor, and wherein the method comprises: receiving data via
a communication
interface relating to a plurality of prescription drug claims transactions
from pharmacy
computers of a plurality of pharmacies that operate independently in relation
to fulfillment of
prescriptions such that the service provider computing device is in common for
the plurality of
independently operating pharmacies, wherein the data that is received relates
to prescription drug
claims transactions that comprise a prescription claim request, a medical
claim request or a
predetermination of benefits request; parsing the data with processing
circuitry to identify a
patient and a prescription drug from a respective prescription drug claims
transaction of the
plurality of prescription drug claims transactions; determining by the
processing circuitry
whether the prescription drug is included in a subset of prescription drugs to
be monitored for
potential misuse; only in an instance in which the prescription drug is
included in the subset,
monitoring for potential misuse by formulating a search query for a database
of prescription drug
claims transactions based upon the patient and the prescription drug
identified from the
respective prescription drug claims transaction and determining by reference
by the processing
circuitry to the database whether prescriptions of the patient related to the
prescription drug that
have been filled at any of one or more pharmacies satisfy criteria indicative
of potential
prescription drug misuse; and in an instance in which the criteria indicative
of the potential
prescription drug misuse is satisfied, causing an electronic notification to
be provided via the
communication interface to a pharmacy that submitted the respective
prescription drug claims
transaction.
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[0006c1 In a further embodiment, there is provided an apparatus of a service
provider
computing device configured to process prescription drug claims transactions
from a plurality of
pharmacy computers operative in a network to identify potential prescription
drug misuse,
wherein the service provider computing device is of a claims processor
configured to process the
prescription drug claims transactions or a service provider that edits the
prescription drug claims
transactions prior to providing the prescription drug claims transactions to
the claims processor,
and wherein the apparatus comprises at least one processor and at least one
memory including
computer program code, the at least one memory and the computer program code
configured to,
with the processor, cause the apparatus to at least: receive data relating to
a plurality of
prescription drug claims transactions from pharmacy computers of a plurality
of pharmacies that
operate independently in relation to fulfillment of prescriptions such that
the service provider
computing device is in common for the plurality of independently operating
pharmacies, wherein
the data that is received relates to prescription drug claims transactions
that comprise a
prescription claim request, a medical claim request or a predetermination of
benefits request
parse the data to identify a patient and a prescription drug from a respective
prescription drug
claims transaction of the plurality of prescription drug claims transactions;
determine whether the
prescription drug is included in a subset of prescription drugs to be
monitored for potential
misuse; only in an instance in which the prescription drug is included in the
subset, monitor for
potential misuse by formulating a search query for a database of prescription
drug claims
transactions based upon the patient and the prescription drug identified from
the respective
prescription drug claims transaction and determine by reference to the
database of prescription
drug claims transactions whether prescriptions of the patient related to the
prescription drug that
have been filled at any of one or more pharmacies satisfy criteria indicative
of potential
prescription drug misuse; and in an instance in which the criteria indicative
of the potential
prescription drug misuse is satisfied, cause a notification to be provided to
a pharmacy that
submitted the respective prescription drug claims transaction.
[0006d] In yet a further embodiment, there is provided a non-transitory
computer-readable
storage medium of a service provider computing device having computer-
executable program
code instructions stored therein that are configured to process prescription
drug claims
transactions from a plurality of pharmacy computers operative in a network to
identify potential
prescription drug misuse, wherein the service provider computing device is of
a claims processor
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configured to process the prescription drug claims transactions or a service
provider that edits the
prescription drug claims transactions prior to providing the prescription drug
claims transactions
to the claims processor, and wherein the computer-executable program code
instructions
comprise program code instructions configured to: receive data relating to a
plurality of
prescription drug claims transactions from pharmacy computers of a plurality
of pharmacies that
operate independently in relation to fulfillment of prescriptions such that
the service provider
computing device is in common for the plurality of independently operating
pharmacies, wherein
the data that is received relates to prescription drug claims transactions
that comprise a
prescription claim request, a medical claim request or a predetermination of
benefits request;
parse the data to identify a patient and a prescription drug from a respective
prescription drug
claims transaction of the plurality of prescription drug claims transactions;
determine whether the
prescription drug is included in a subset of prescription drugs to be
monitored for potential
misuse; only in an instance in which the prescription drug is included in the
subset, monitor for
potential misuse by formulating a search query for a database of prescription
drug claims
transactions based upon the patient and the prescription drug identified from
the respective
prescription drug claims transaction and determine by reference to the
database of prescription
drug claims transactions whether prescriptions of the patient related to the
prescription drug that
have been filled at any of one or more pharmacies satisfy criteria indicative
of potential
prescription drug misuse; and in an instance in which the criteria indicative
of the potential
prescription drug misuse is satisfied, cause a notification to be provided to
a pharmacy that
submitted the respective prescription drug claims transaction.
[0007] In an example embodiment, a system is provided that is configured to
process
prescription drug claims transactions from a plurality of pharmacy computers
operative in a
network to identify potential prescription drug misuse. The system includes a
database of
prescription drug claims transactions, a communication interface configured to
receive data
relating to a prescription drug claims transaction and processing circuitry.
The processing
circuitry is configured to parse the data to identify a patient and a
prescription drug from the
prescription drug claims transaction and to determine whether the prescription
drug is included
in a subset of prescription drugs to be monitored for potential misuse. The
processing circuitry is
also configured, in an instance in which the prescription drug is included in
the subset, to
formulate a search query for the database of prescription drug claims
transactions based upon the
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patient and the prescription drug identified from the prescription drug claims
transaction and to
determine by reference to the database of prescription drug claims
transactions whether
prescriptions of the patient related to the prescription drug that have been
filled at any of one or
more pharmacies satisfy criteria indicative of potential prescription drug
misuse. The
communication interface is also configured, in response to a determination by
the processing
circuitry that the criteria indicative of the potential prescription drug
misuse is satisfied, to cause
a notification to be provided to a pharmacy that submitted the prescription
drug claims
transaction.
100081 The processing circuitry of an example embodiment is configured to
determine
whether the prescriptions for the patient related to the prescription drug
satisfy the criteria by
determining whether one or more prescriptions of the patient related to the
prescription drug
from one or more prior prescription drug claims transactions in combination
with the
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.... ...
prescription drug from the prescription drug claims transaction that has been
received satisfy the
criteria indicative of potential prescription drug misuse. The one or more
prescriptions of the
patient related to the prescription drug may include one or more prescriptions
of the patient for a
prescription drug of a same class of prescription drugs as the prescription
drug from the
prescription drug claims transaction that has been received. At least one of
the one or more
prescriptions of the patient related to the prescription drug may include a
prescription of the
patient for a different prescription drug than the prescription drug from the
prescription drug
claims transaction that has been received. In this example embodiment, the
different prescription
drug and the prescription drug from the prescription drug claims transaction
that has been
received are within the same class of prescription drugs.
[0009] The processing circuitry of an example embodiment is further
configured, in an
instance in which the prescription drug is included in the subset, to create a
prescription drug
record including at least the patient and the prescription drug of the
prescription drug transaction
and to store the prescription drug record in the database. The processing
circuitry of this
example embodiment is also configured to determine whether the prescriptions
for the patient
related to the prescription drug satisfy the criteria by accessing, from the
database, one or more
prescription drug records of the patient associated with the one or more prior
prescription drug
claims transactions. The processing circuitry may be further configured to
associate the
prescription drug record in the database with a patient record associated with
the patient and also
stored by the database.
[0010] In an example embodiment, a computer-implemented method is provided
for
processing prescription drug claims transactions from a plurality of pharmacy
computers
operative in a network to identify potential prescription drug misuse. The
method includes
receiving data via a communication interface relating to a prescription drug
claims transaction
and parsing the data with processing circuitry to identify a patient and a
prescription drug from
the prescription drug claims transaction. The method also determines by the
processing circuitry
whether the prescription drug is included in a subset of prescription drugs to
be monitored for
potential misuse. In an instance in which the prescription drug is included in
the subset, the
method formulates a search query for a database of prescription drug claims
transaction based
upon the patient and the prescription drug identified from the prescription
drug claims
transaction and determines by reference by the processing circuitry to the
database whether
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=
prescriptions of the patient related to the prescription drug that have been
filled at any of one or
more pharmacies satisfy criteria indicative of potential prescription drug
misuse. In an instance
in which the criteria indicative of the potential prescription drug misuse is
satisfied, the method
causes an electronic notification to be provided by the communication
interface, such as by
causing an alert to be provided to the pharmacy that submitted the
prescription drug claims
transaction.
[0011] The method of an example embodiment determines whether the
prescriptions for the
patient related to the prescription drug satisfy the criteria by determining
whether one or more
prescriptions of the patient related to the prescription drug from one or more
prior prescription
drug claims transactions in combination with the prescription drug from the
prescription drug
claims transaction that has been received satisfy the criteria indicative of
potential prescription
drug misuse. In an example embodiment, one or more prescriptions of the
patient related to the
prescription drug include one or more prescriptions of the patient for a
prescription drug of the
same class of prescription drugs as the prescription drug from the
prescription drug claims
transaction that has been received. Thus, at least one of the one or more
prescriptions of the
patient related to the prescription drug may include a prescription of the
patient for a different
prescription drug than the prescription drug from the prescription drug claims
transaction that
has been received. However, the different prescription drug and the
prescription drug from the
prescription drug claims transaction that has been received are within the
same class of
prescription drugs.
[0012] In an instance in which the prescription drug is included in the
subset, the method of
an example embodiment creates a prescription drug record including at least
the patient and the
prescription drug of the prescription drug transaction and stores the
prescription drug record in a
database. In this embodiment, the method determines whether the prescriptions
for the patient
related to the prescription drug satisfy the criteria by accessing, from the
database, one or more
prescription drug records of the patient associated with the one or more
prescription drug claims
transactions. The method of this example embodiment may also include
associating the
prescription drug record in the database with a patient record associated with
the patient and also
stored by the database.
[0013] In another example embodiment, an apparatus is provided that is
configured to
process prescription drug claims transactions from a plurality of pharmacy
computers operative
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in a network to identify potential prescription drug misuse. The apparatus
includes at least one
processor and at least one memory including computer program code with the at
least one
memory and the computer program code configured to, with the processor, cause
the apparatus
to at least receive data relating to a prescription drug claims transaction
and to parse the data to
identify a patient and a prescription drug from the prescription drug claims
transaction. The at
least one memory and the computer program code are also configured to, with
the processor,
cause the apparatus to determine whether the prescription drug is included in
a subset of
prescription drugs to be monitored for potential misuse. In an instance in
which the prescription
drug is included in the subset, the at least one memory and the computer
program code are
further configured to, with the processor, cause the apparatus to formulate a
search query for a
database of prescription drug claims transaction based upon the patient and
the prescription drug
identified from the prescription drug claims transaction and determine by
reference by the
processing circuitry to the database whether prescriptions of the patient that
are related to the
prescription drug satisfy criteria indicative of potential prescription drug
misuse. In an instance
in which the criteria indicative of the potential prescription drug misuse is
satisfied, the at least
one memory and the computer program code are further configured to, with the
processor, cause
the apparatus to cause an electronic notification to be provided, such as by
causing an alert to be
provided to the pharmacy that submitted the prescription drug claims
transaction.
10014] The at
least one memory and the computer program code are configured to, with the
processor, cause the apparatus of an example embodiment to determine whether
the prescriptions
for the patient related to the prescription drug satisfy the criteria by
determining whether one or
more prescriptions of the patient related to the prescription drug from one or
more prior
prescription drug claims transactions in combination with the prescription
drug from the
prescription drug claims transaction that has been received satisfy the
criteria indicative of
potential prescription drug misuse. In an example embodiment, the one or more
prescriptions of
the patient related to the prescription drug include one or more prescriptions
of the patient for a
prescription drug of the same class of prescription drugs as the prescription
drug from the
prescription drug claims transaction that has been received. As such, at least
one of the one or
more prescriptions of the patient related to the prescription drug may include
a prescription of
the patient for a different prescription drug than the prescription drug from
the prescription drug
claims transaction that has been received. However, the different prescription
drug and the
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õ
prescription drug from the prescription drug claims transaction that has been
received are within
the same class of prescription drugs.
[0015] The at least one memory and the computer program code are further
configured to,
with the processor, cause the apparatus of an example embodiment to create, in
an instance in
which the prescription drug is included in the subset, a prescription drug
record including at least
the patient and the prescription drug of the prescription drug transaction and
to store the
prescription drug record in a database. The at least one memory and the
computer program code
are configured to, with the processor, cause the apparatus of this example
embodiment to
determine whether the prescriptions for the patient related to the
prescription drug satisfy the
criteria by accessing, from the database, one or more prescription drug
records of the patient
associated with the one or more prior prescription drug claims transactions.
The at least one
memory and the computer program code are further configured to, with the
processor, cause the
apparatus to associate the prescription drug record in the database with a
patient record
associated with the patient and also stored by the database.
[00161 In a further example embodiment, a computer program product is
provided that is
configured to process prescription drug claims transactions from a plurality
of pharmacy
computers operative in a network to identify potential prescription drug
misuse. The computer
program product includes at least one non-transitory computer-readable storage
medium having
computer-executable program code instructions stored therein with the computer-
executable
program code instructions including program code instructions configured to
receive data
relating to a prescription drug claims transaction and to parse the data to
identify a patient and a
prescription drug from a prescription drug claims transaction. The computer-
executable program
code instructions also include program code instructions configured to
determine whether the
prescription drug is included in a subset of prescription drugs to be
monitored for potential
misuse. In an instance in which the prescription drug is included in the
subset, the
computer-executable program code instructions further include program code
instructions
configured to formulate a search query for a database of prescription drug
claims transaction
based upon the patient and the prescription drug identified from the
prescription drug claims
transaction and determine by reference by the processing circuitry to the
database whether
prescriptions of the patient related to the prescription drugs satisfy
criteria indicative of potential
prescription drug misuse. In an instance in which the criteria indicative of
the potential for
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prescription drug misuse is satisfied, the computer-executable program code
instructions
additionally include program code instructions configured to cause an
electronic notification to
be provided, such as by causing an alert to be provided to a pharmacy that
submitted the
prescription drug claims transaction.
100171 The program code instructions of an example embodiment that are
configured to
determine whether the prescriptions for the patient related to the
prescription drug satisfy the
criteria include program code instructions configured to determine whether one
or more
prescriptions of the patient related to the prescription drug from one or more
prior drug claims
transactions in combination with the prescription drug from the prescription
drug claims
transaction that has been received satisfy the criteria indicative of
potential prescription drug
misuse. In this example embodiment, the one or more prescriptions of the
patient related to the
prescription drug include one or more prescriptions of the patient for a
prescription drug of the
same class of prescription drugs as a prescription drug from the prescription
drug claims
transaction that has been received. In this example embodiment, at least one
of the one or more
prescriptions of the patient related to the prescription drug includes a
prescription of the patient
for a different prescription drug than the prescription drug from the
prescription drug claims
transaction that has been received. However, the different prescription drug
and the prescription
drug from the prescription drug claims transaction that has been received are
within the same
class of prescription drugs.
10018] The computer-executable program code instructions of an example
embodiment also
include program code instructions configured to create, in an instance in
which the prescription
drug is included in the subset, a prescription drug record including at least
the patient and the
prescription drug of the prescription drug claims transaction and to store the
prescription drug
record in the database. In this example embodiment, the program code
instructions configured to
determine whether the prescriptions for the patient related to the
prescription drug satisfy the
criteria further include program code instructions configured to access, from
the database, one or
more prescription drug records of the patient associated with the one or more
prior prescription
drug claims transactions. The computer-executable program code instructions of
this example
embodiment may also include program code instructions configured to associate
the prescription
drug record in the database with a patient record associated with the patient
and also stored by
the database.
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BRIEF DESCRIPTION OF THE DRAWINGS
[0019] Having thus described certain embodiments of the invention in
general terms,
reference will now be made to the accompanying drawings, which are not
necessarily drawn to
scale, and wherein:
[0020] Figure 1 is a block diagram of one example of a system for
submitting and evaluating
prescription drug claims transactions in order to identify potential
prescription drug misuse in
accordance with an example embodiment;
[0021] Figure 2 is a block diagram of an apparatus that may be specifically
configured in
order to identify potential prescription drug misuse in accordance with an
example embodiment;
[0022] Figure 3 is a flow chart illustrating operations performed, such as
by the apparatus of
Figure 2, in order to identify potential prescription drug misuse in
accordance with an example
embodiment; and
[0023] Figure 4 is a representation of a database including a file
containing patient records
and a file containing prescription drug records that may be accessed in
conjunction with the
identification of potential prescription drug misuse in accordance with an
example embodiment.
DETAILED DESCRIPTION
[0024] The present invention now will be described more fully hereinafter
with reference to
the accompanying drawings, in which some, but not all embodiments of the
inventions are
shown. Indeed, these inventions may be embodied in many different forms and
should not be
construed as limited to the embodiments set forth herein; rather, these
embodiments are provided
so that this disclosure will satisfy applicable legal requirements. Like
numbers refer to like
elements throughout.
[0025] A system, method, apparatus and computer program product are
provided in
accordance with an example embodiment in order to identify potential
prescription drug misuse.
As described below, the system, method, apparatus and computer program product
are
configured to identify potential prescription drug misuse even in an instance
in which a patient
presents prescriptions for the prescription drug for fulfillment at a number
of different
pharmacies including pharmacies that otherwise operate relatively
independently, at least in
regard to the fulfillment of prescriptions. The system, method, apparatus and
computer program
product of an example embodiment may be configured to identify potential
prescription drug
misuse for any of a wide variety of different prescription drugs. In an
example embodiment,
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however, the system, method, apparatus and computer program product are
configured to
identify potential prescription drug misuse for the class of prescription
drugs that includes
opioids since the deleterious impact of potential prescription drug misuse of
prescription drugs in
the class that includes opioids can have devastating consequences and further,
since prescription
drugs in the same class as opioids can be addictive.
[0026] Although the method, apparatus and computer program product of an
example
embodiment may be deployed in a variety of different systems, one example of a
system 10 in
which the method, apparatus and computer program product for identifying
potential prescription
drug misuse are deployed is depicted in Figure 1. As shown, the system
includes a plurality of
pharmacies 12 at which prescriptions may be fulfilled, such as Pharmacy 1,
Pharmacy 2, ...
Pharmacy n in the embodiment of Figure 1. In relation to the fulfillment of
prescriptions and
interaction with the patients, the pharmacies may operate in a coordinated
manner or in a
relatively autonomous manner. However, pharmacy computers of the pharmacies
(hereinafter
collectively referenced as "pharmacies") of this embodiment of a system are
configured to create
and provide prescription drug claims transactions via a network to a service
provider 14, such as
a claims processor or other form of service provider that processes and stores
the prescription
drug claims transactions, such as a service provider that pre-edits the
prescript drug claims
transactions prior to providing the prescription drug claims transactions to a
claims processor for
evaluation and/or that provides various other value-added services. The claims
processor may be
associated with a payor, such as an insurance company, a governmental entity
or the like, and
may be configured to evaluate prescription drug claims transactions in order
to determine the
financial responsibility for the prescription drug claims transaction, such as
the financial
responsibility of the patient, the financial responsibility of the payor or
the like.
[0027] Various types of prescription drug claims transactions may be
provided by a
pharmacy 12 and processed by a service provider 14 including, for example, a
prescription claim
request, medical claim request, predetermination of benefits request or the
like. In this regard, a
predetermination of benefits request solicits information, such as information
indicative of the
amount that the patient will be required to pay for a prescription drug in
advance of the
submission of a prescription claim request or a medical claim request seeking
reimbursement of
the patient, such as following fulfillment of and payment for the prescription
drug.
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[0028] As shown, even in an embodiment in which the system 10 includes a
plurality of
pharmacies 12, such as a plurality of pharmacies that operate independently in
relation to the
fulfillment of prescriptions, the pharmacies of an example embodiment submit
prescription drug
claims transactions to a common service processor 14 for processing and/or
evaluation. Since
the plurality of pharmacies submit prescription drug claims transactions to a
common service
processor, the service processor may be configured in accordance with an
example embodiment
in order to evaluate the prescription drug claims transactions from one or
more pharmacies in
order to identify potential prescription drug misuse based on prescriptions
filled at the one or
more pharmacies, such as in an instance in which the prescriptions filled at a
plurality of
pharmacies may represent potential prescription drug misuse in the aggregate
even though the
prescriptions filled at any one pharmacy would not, in and of itself,
represent potential
prescription drug misuse.
[0029] In accordance with an example embodiment, an apparatus 20 is
provided that is
specifically configured to identify potential prescription drug misuse. The
apparatus of this
example embodiment may be embodied by a computing device, such as a server, a
computer
workstation, one or more distributed computers or the like. In an example
embodiment, the
apparatus is associated with the service provider 14 of the system 10 of
Figure 1 and, as such,
may be embodied by a switch or a router and may be configured to interact with
a plurality of
pharmacies 12 and, more typically, a plurality of pharmacy management systems
utilized by the
plurality of pharmacies in order to submit prescription drug claims
transactions to the service
provider. Although the apparatus may be configured in various manners, the
apparatus of an
example embodiment may be embodied as shown in Figure 2 so as to include, be
in association
with or otherwise be in communication with processing circuitry 22 that is
configurable to
perform actions in accordance with example embodiments described herein. The
processing
circuitry may be configured to perform data processing, application execution
and/or other
processing and management services. The processing circuitry may include at
least one
processor and may, in one embodiment, be in communication with or otherwise
control a
memory 24, a communication interface 26 and a database 28. The apparatus may
also include
the communication interface and the database as shown in Figure 2, or the
communication
interface and/or the database may be separate from, but in communication with,
the apparatus.
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=
[0030] In an example embodiment, the memory 24 may include one or more non-
transitory
memory devices such as, for example, volatile and/or non-volatile memory that
may be either
fixed or removable. The memory may be configured to store information, data,
applications,
instructions or the like for enabling the apparatus 20 to carry out various
functions in accordance
with example embodiments of the present invention. For example, the memory
could be
configured to buffer input data for processing by the processing circuitry 22.
Additionally, or
alternatively, the memory could be configured to store instructions for
execution by the
processing circuitry.
[0031] The processing circuitry 22 may be embodied in a number of
different ways. For
example, the processing circuitry may be embodied as various processing means
such as at least
one processor that may be embodied by one or more of a microprocessor or other
processing
element, a coprocessor, a controller or various other computing or processing
devices including
integrated circuits such as, for example, an ASIC (application specific
integrated circuit), an
FPGA (field programmable gate array), or the like. In an example embodiment,
the processing
circuitry may be configured to execute instructions stored in the memory 24 or
otherwise
accessible to the processing circuitry. As such, whether configured by
hardware or by a
combination of hardware and software, the processing circuitry may represent
an entity (e.g.,
physically embodied in circuitry ¨ in the form of processing circuitry)
specifically configured to
perform operations according to embodiments of the present invention while
configured
accordingly. Thus, for example, when the processing circuitry is embodied as
an ASIC, FPGA
or the like, the processing circuity may be specifically configured hardware
for conducting the
operations described herein. Alternatively, as another example, when the
processing circuitry is
embodied as an executor of software instructions, the instructions may
specifically configure the
processing circuitry to perform the operations described herein.
[0032] The communication interface 26 may include one or more interface
mechanisms for
enabling communication with the pharmacies 12 and/or a claims processor, such
as one or more
input/output (I/0) interfaces. In this regard, the communication interface may
include, for
example, an antenna (or multiple antennas) and supporting hardware and/or
software for
enabling the communications therewith.
[0033] The database 28 may be embodied by any of a variety of data storage
devices such as
a Network Attached Storage (NAS) device or devices, or as a separate database
server or servers.
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The database includes information accessed and stored by the processing
circuitry 22 to facilitate
the operations of the service provider 14. For example, the database may
comprise a plurality of
files storing patient records and prescription drug records as described
below.
[0034] The operations performed, such as by the apparatus 20 of Figure 2,
in accordance
with an example embodiment are depicted in Figure 3, such as from the
perspective of the
service provider 14. As shown in block 30 of Figure 3, the apparatus includes
means, such as the
processing circuitry 22, the communication interface 26 or the like,
configured to receive data
relating to a prescription drug claims transaction. The data relating to the
prescription drug
claims transaction that is received may be the prescription drug claims
transaction itself, such as
a predetermination of benefits request, a prescription claim request, a
medical claim request or
the like. However, in some embodiments, the prescription drug claims
transaction is processed
prior to receipt by the apparatus and data relating to the prescription drug
claims transaction is
provided to the apparatus even though the prescription drug claims transaction
itself is not
provided.
[0035] As shown in block 32 of Figure 3, the apparatus 20 also includes
means, such as the
processing circuitry 22 or the like, configured to parse the data relating to
the prescription drug
claims transaction so as to identify the patient and the prescription drug
from the prescription
drug claims transaction. In this regard, the prescription drug claims
transaction may include a
plurality of fields organized in a predefined manner. These fields include,
among other
parameters, data that identifies the patient and data that identifies the
prescription drug. The
patient may be identified in various manners including, for example, the name
of the patient, a
patient identification number, such as may be uniquely assigned to a patient
in some
jurisdictions, such as Canada or the like, and/or combinations of other
information related to the
patient, such as the address of the patient, the date of birth of the patient
and the like.
100361 Although different types of prescription drug claims transactions
may include
different fields, the request of one example embodiment includes the following
fields:
Purchase plan identifier - Payor ID / Routing Information
o BIN Number (i.e. Banking Identification Number); BIN Number and Processor
Control Number (PCN); BIN Number and Group ID; BIN Number, PCN and
Group ID; BIN Number, PCN, Group ID, and Cardholder ID (of purchaser); BIN
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Number, PCN, Group ID, Cardholder ID (of purchaser), Relationship Code (of
purchaser), and Person Code (of purchaser); and/or BIN Number, PCN, Group
ID, Cardholder ID (of purchaser), Relationship Code (of purchaser), Person
Code
(of purchaser), Purchaser Date of Birth, and Purchaser Gender that designates
a
destination of the request
Purchaser Information
o Name (e.g. Purchaser Last Name, Purchaser First Name, etc.)
o Date of Birth of Purchaser
o Gender of Purchaser
o Purchaser Address (e.g. Street Address, Zip Code, etc.)
o Purchaser Contact Information (e.g. purchaser telephone number, email
address,
etc.)
o Purchaser ID or other identifier (e.g., driver's license number, social
security
number, Health Insurance Claim Number (HICN), etc.)
Purchase Plan Information
o Cardholder Name (e.g. Cardholder First Name, Cardholder Last Name)
o Cardholder ID and/or other identifier (e.g. person code)
o Group ID and/or Group Information
Transaction Type
o Transaction Type Code (e.g., product purchase request (e.g., billing
transaction),
reversal transaction, e-script transaction, benefits determination request)
Prescriber of the Product Information
o Prescriber ID or other identifier (e.g. prescriber code)
o Prescriber Name (e.g. Last Name, First Name)
o Prescriber Contact Information (e.g. Telephone Number)
Merchant Information
o Merchant Information (e.g. store name, store address, chain identifier,
etc.)
o Merchant ID (e.g. merchant code)
Product Information
o Product information ¨ Product or service identifier (e.g. product code,
UPC code,
NDC code, etc.), product or service name, etc.
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o Purchase Reference Number
o Quantity of Product to be Dispensed
o Days' Supply of the Product Purchased
o Pricing information for the product or service (e.g. ingredient cost
(e.g., in an
Ingredient Cost field), dispensing fee (e.g., in a Dispensing Fee field),
gross
amount due (e.g., in a Gross Amount Due field), and Usual and Customary
Charge amount (e.g., in a Usual and Customary Charge field))
o Number of Refills Authorized
o Fill Number (i.e., the current refill number for the current request)
o Transaction Submission Date of the Request (the original date that the
Request
was electronically submitted to the claims processor).
10037] In an
example embodiment, the apparatus 20 includes means, such as the processing
circuitry 22 or the like, to determine whether the patient record exists for
the patient identified
from the prescription drug claims transaction. See block 34 of Figure 3. As
shown generally in
Figure 2 and more particularly in Figure 4, the apparatus may include or
otherwise be associated
with or in communication with a database 28 that includes a file 60 storing
patient records. Each
patient record is associated with a patient for which a prescription drug
claims transaction has
been submitted to the service provider 14. Although a patient record may
include a variety of
different information related to the patient, the patient record of an example
embodiment
includes one or more of a patient identification number, the first name of the
patient, the last
name of the patient, the date of birth of the patient, the gender of the
patient and/or the address of
the patient. In an instance in which the apparatus, such as the processing
circuitry, determines
that a patient record has not previously been created for the patient
associated with a prescription
drug claims transaction that is being evaluated, the apparatus includes means,
such as the
processing circuitry or the like, for creating a patient record, such as in
the file of patient records
maintained by the database. See block 36 of Figure 3. As noted above, the
patient record that is
created includes information regarding the patient that uniquely identifies
the patient and, in one
embodiment, includes information identifying the patient that is parsed from
the data related to
the prescription drug claims transaction that was received.
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=
[0038] In an instance in which a patient record already exists for the
patient associated with
the prescription drug claims transaction or in an instance in which a patient
record has been
created for the patient associated with the prescription drug claims
transaction, the apparatus 20
includes means, such as the processing circuitry 22 or the like, configured to
determine whether
the prescription drug is included in a subset of prescription drugs to be
monitored for potential
misuse. See block 38 of Figure 3. Although all prescription drugs could be
monitored for
potential misuse, the apparatus of an example embodiment provides a technical
advantage by
being tailored to only monitor a subset of prescription drugs for potential
misuse, such as the
subset of prescription drugs that are addictive, that may cause the most
deleterious effects if
taken in an unregulated manner or the like. For example, the apparatus could
be configured to
monitor prescription drug claims transactions for opioids, but not for
prescription drug claims
transactions for prescription drugs other than opioids. By evaluating only a
subset of
prescription drugs for potential misuse, the apparatus of this example
embodiment can more
efficiently process the prescription drug claims transactions, such as by
processing the
prescription drug claims transactions in a more timely manner and in a manner
that consumes
fewer processing resources since the prescription drug claims transactions for
prescription drugs
that are not included in the subset of prescription drugs to be monitored for
misuse need not be
subjected to the additional processing described herein to which prescription
drug claims
transactions for prescription drugs that are included in the subset of
prescription drugs to be
monitored for misuse are subjected.
100391 The apparatus 20, such as the processing circuitry 22, may be
configured to determine
whether the prescription drug is included in a subset of prescription drugs to
be monitored for
potential misuse in various manners. In this regard, the subset of
prescription drugs to be
monitored for potential misuse may be defined in various manners. In one
embodiment, for
example, a list of prescription drugs to be monitored for potential misuse is
maintained, such as
by the memory 24, the database 28, the processing circuitry or the like. In
some embodiments,
the list of prescription drugs to be monitored for potential misuse may
include a list of all of the
prescription drugs themselves to be monitored for potential misuse. In another
embodiment, the
list of prescription drugs to be monitored for potential misuse may include a
list of one or more
classes of prescription drugs to be monitored for potential misuse either with
or without listing
the individual prescription drugs of each class.
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[0040] In an instance in which the prescription drug from the prescription
drug claims
transaction is not included in the subset of prescription drugs to be
monitored for potential
misuse, the prescription drug claims transaction may be processed in a
conventional manner. For
example, the apparatus 20, such as the processing circuitry 22, the memory 24,
the database 28
or the like, may be configured to create a prescription drug record indicative
of the prescription
drug that is the subject of the prescription drug claims transaction. See
block 40 of Figure 3.
The prescription drug record may include various information identifying or
associated with the
prescription drug including the patient to which the prescription drug was
prescribed, such as
may be identified by the patient identification number, the date that the
prescription was filled,
the date that the prescription was submitted, the quantity of the prescription
drug, the days
supply of the prescription drug, information identifying the pharmacy, such as
the pharmacy
identifier (ID), information identifying the prescriber of the prescription
drug, such as the
prescriber ID and a link to the patient record stored by the database that is
associated with the
patient to whom the prescription drug claims transaction relates. The
apparatus, such as the
processing circuitry, the database or the like, may also be configured to
cause the resulting
prescription drug record to be stored by the database, such as by a file 62 of
prescription drug
records maintained by the database. See block 42 of Figure 3.
[0041] The apparatus 20, such as the processing circuitry 22, of this
example embodiment is
also then configured to process the prescription drug claims transaction, such
as in a
conventional manner. See block 44 of Figure 3. The apparatus, such as the
processing circuitry,
the communication interface 26 or the like, may also be configured to cause a
response to the
prescription drug claims transaction to be provided as shown in block 46. In
some embodiments,
the apparatus, such as the processing circuitry, creates and stores a
prescription drug record and
then causes a response to be transmitted to the pharmacy that submitted the
prescription drug
claims transaction indicating of receipt and storage of the prescription drug
claims transaction.
In other embodiments, however, the prescription drug claims transaction may be
processed, such
as to identify the amount that the patient will be required to pay for the
fulfillment of the
prescription, such as in an instance in which the prescription drug claims
transaction is a
predetermination of benefits request or to submit the prescription drug claims
transaction to a
payor, such as an insurance company, for reimbursement of the patient or the
pharmacy 12 for
fulfillment of the prescription. In these embodiments, the apparatus, such as
the processing
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circuitry, may be configured to interact with a claims processor and is
configured to not only
cause a response to be provided to the pharmacy indicative of the receipt and
storage of the
prescription drug claims transaction, but also to provide information
following processing of the
prescription drug claims transaction.
[0042] In an instance in which the apparatus 20, such as the processing
circuitry 22,
determines that the prescription drug of the prescription drug claims
transaction is included in a
subset of prescription drugs to be monitored for potential misuse, the
apparatus includes means,
such as the processing circuitry, the database 28 or the like, configured to
create a prescription
drug record and cause the resulting prescription drug record to be stored,
such as in the database,
in the manner described above. See blocks 48 and 50 of Figure 3. In an example
embodiment,
the apparatus, such as the processing circuitry, provides technical advantages
by not merely
creating and storing a prescription drug record for a prescription drug that
is included within the
subset of prescription drugs to be monitored for potential misuse, but,
instead, creates a
prescription drug record and/or stores the resulting prescription drug record
within the database
in such a manner that the prescription drug record for the prescription drug
that is included in the
subset of prescription drugs to be monitored for potential misuse is
distinguishable and
identifiable relative to the prescription drug records created and stored for
prescription drugs that
are not included in the subset of prescription drugs to be monitored for
potential misuse. As
such, prescription drug records for prescription drugs that are included in
the subset of
prescription drugs to be monitored for potential misuse may be readily and
efficiently identified
during subsequent analysis, thereby conserving processing and memory resources
and reducing
processing time in comparison to instances in which all of the prescription
drug records stored by
the database would need to be evaluated. The prescription drug records for
prescription drugs
included in the subset of prescription drugs to be monitored for potential
misuse may be
identified in various manners including by the inclusion of a flag, a tag or
other identifier within
the prescription drug record itself and/or by the storage of a prescription
drug record for
prescription drugs included in the subset of prescription drugs to be
monitored for potential
misuse not only within the file 62 of prescription drug records maintained by
the database, but
within a subfile 64 of the file of prescription drug records that is
configured to store only those
prescription drug records for prescription drugs included in the subset of
prescription drugs to be
monitored for potential misuse.
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[0043] In an instance in which the prescription drug is determined to be
within the subset of
prescription drugs to be monitored for potential misuse and after having
created the prescription
drug record and stored the prescription drug record in the database 28, the
apparatus 20 of an
example embodiment includes means, such as the processing circuitry 22 or the
like, configured
to formulate a search query for the database of prescription drug claims
transaction based upon
the patient and the prescription drug identified from the prescription drug
claims transaction and
to determine by reference to the database, such as by searching the database
based upon the
search query, as to whether prescriptions of the patient (that is, the patient
associated with the
prescription drug claims transaction that is being evaluated) related to the
prescription drug that
have been filled at any of one or more pharmacies 12, such as prescriptions of
the patient filled at
a plurality of different pharmacies, satisfy criteria indicative of potential
prescription drug
misuse. See block 52 of Figure 3. In an example embodiment, the apparatus,
such as the
processing circuitry, is configured to determine whether the prescriptions of
the patient related to
the prescription drug satisfy the criteria by initially accessing the
prescription drug records stored
by the database for the same patient, such as by accessing the prescription
drug records stored by
the database that are linked or otherwise associated with the same patient
with which the
prescription drug claims transaction under evaluation is related.
[0044] Of the prescription drug records for the same patient, the apparatus
20, such as the
processing circuitry 22, is configured to evaluate the prescription drug
record related to the
prescription drug that is the subject of the prescription drug claims
transaction. While the
apparatus, such as the processing circuitry, of an example embodiment is
configured to evaluate
the prescription drug records of the patient for the exact same prescription
drug that is the subject
of the prescription drug claims transaction under evaluation, the apparatus,
such as the
processing circuitry, of an example embodiment is configured to evaluate
prescriptions of a
patient that are related to the prescription drug so as to identify not only
prescriptions for the
exact same prescription drug as the prescription drug claims transaction under
evaluation, but
any prescription of the patient for a prescription drug within the same class
of prescription drugs
as the prescription drug that is the subject of the prescription drug claims
transaction that is
currently being evaluated. In this example embodiment, the prescription drug
records may also
include a parameter identifying the class of prescription drug and/or the
memory 24 may store a
list of prescription drugs that form each of a plurality of different classes
of prescription drugs
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........ .
such that the apparatus, such as the processing circuitry, is configured to
identify the other
prescription drugs of the same class as the prescription drug that is
associated with the
prescription drug claims transaction under evaluation.
[0045] For example, the prescription drug claims transaction may relate to
one particular
opioid. However, the apparatus 20, such as the processing circuitry 22, of an
example
embodiment may be configured to identify the prescription drug records for the
patient related to
any prescription drug within the class of prescription drugs that includes the
particular opioid
that is the subject of the prescription drug claims transaction under
evaluation since potential
drug misuse may involve the use of not only the particular opioid identified
by the prescription
drug claims transaction under evaluation, but the fulfillment of prior
prescriptions for any of a
variety of opioids of the same class. Thus, in some embodiments, at least one
or more
prescriptions of the patient that are related to the prescription drug and are
identified and
evaluated for purposes of determining whether the prescriptions satisfy
criteria indicative of
potential prescription drug misuse include a prescription of the patient for a
different prescription
drug, then the prescription drug of the prescription drug claims transaction
that is currently being
evaluated. In this embodiment, however, the different prescription drug and
the prescription
drug from the prescription drug claims transaction that is currently being
evaluated are within the
same class of prescription drugs.
[0046] The criteria indicative of potential prescription drug misuse may be
defmed in various
manners. For example, the criteria may be defined in terms of the quantity of
the same
prescription drug or the quantity of prescriptions drugs of the same class
that have obtained by
the same patient from any the one or more pharmacies 12, such as within a
predefined period of
time preceding the current date and time. In some embodiments, the criteria
may also take into
account the number of different pharmacies at which the prescriptions have
been fulfilled, the
number of different prescriptions fulfilled or the like with an increase in
the number of
pharmacies at which the prescriptions are fulfilled and/or an increase the
number of prescriptions
that are fulfilled being more indicative of potential misuse.
[0047] The apparatus 20, such as the processing circuitry 22, of an example
embodiment is
configured to weight the prescriptions of the patient related to the
prescription drug in various
manners and to then determine whether the prescriptions satisfy the criteria
by evaluating the
weighted impact of the prescriptions in conjunction with the satisfaction, or
not, of the criteria
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indicative of the potential prescription drug misuse. For example, in some
embodiments in
which the prescription drug records that are evaluated for potential misuse
include prescription
drug records of different prescription drugs from within the same class of
prescription drugs, the
apparatus, such as the processing circuitry, may be configured to weight the
prescriptions for the
different prescription drugs differently depending upon various factors
related to the prescription
drugs, such as the deleterious effects caused by abuse of the prescription
drug, the addictive
nature of the prescription drug, and/or the inter-drug interactions associated
with the prescription
drug or the like. Thus, prescriptions for prescription drugs that are more
addictive, cause more
deleterious effects and/or create stronger drug-drug interactions may be
weighted more greatly
than prescriptions for other drugs that are less addictive, cause less
deleterious effects and/or
create fewer drug-drug interactions. Other factors that may be taken into
account by the
apparatus, such as the processing circuitry, in relation to weighting the
different prescriptions
may include the time at which the prescriptions were fulfilled, such as with
older prescriptions
being weighted more lightly than more recent prescriptions.
[0048] In an instance in which the criteria indicative of potential
prescription drug abuse is
not satisfied, the apparatus 20, such as the processing circuitry 22, is
configured in an example
embodiment to process the prescription drug claims transaction in a
conventional manner as
described above, such as in conjunction with blocks 44 and 46 of Figure 3.
However, in an
instance in which the criteria indicative of the potential prescription drug
abuse is satisfied, the
apparatus includes means, such as the processing circuitry, the communication
interface 26 or
the like, configured to cause an electronic notification to be provided. See
block 54 of Figure 3.
Although a variety of electronic notifications may be provided, the apparatus,
such as the
processing circuitry, of an example embodiment is configured to provide an
electronic
notification in the form of an alert to the pharmacy 12 that submitted the
prescription drug claims
transaction. This alert identifies for the pharmacy that fulfillment of the
prescription by the
patient would satisfy the criteria indicative of potential prescription drug
misuse such that the
pharmacist may intervene. Such intervention may take many forms including a
declination by
the pharmacy to fulfil the prescription and/or counseling by the pharmacist as
to the dangers
associated with misuse of the prescription drug. Additionally or
alternatively, the intervention
may include the referral of the patient to a program, such as a counseling
program, designed to
inform the patient as to the dangers associated with misuse of the
prescription drug and/or the
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referral of the patient to the healthcare provider who wrote the prescription
such that the
healthcare provider can determine if the patient could alternatively be
prescribed a different
prescription drug in order to address the symptoms exhibited by the patient,
but in a manner that
would not create the potential for prescription drug misuse. In addition to or
instead of notifying
the pharmacy, the apparatus, such as the processing circuitry, the
communication interface or the
like, may cause the electronic notification, such as an alert, to be provided
to the healthcare
provider who wrote the prescription that is the subject of the prescription
drug claims
transaction.
[0049] As described above, a method, apparatus 20 and computer program
product are
provided in order to identify potential prescription drug misuse by evaluating
the prescriptions of
the patient that have been filled at any of one or more pharmacies including
prescriptions filled at
a plurality of different pharmacies. Thus, potential prescription drug misuse
is identified even in
instances in which a patient presents prescriptions for fulfillment at a
variety of different
pharmacies and even in an instance in which the prescriptions of the patient
filled at any one
particular pharmacy are within the authorized limits and do not satisfy the
criteria indicative of
potential prescription drug misuse. In an instance in which potential
prescription drug misuse is
identified, an electronic notification, such as an alert, may be provided,
such as to the pharmacy
and/or the healthcare provider prescribing the prescription drug, such that
appropriate
intervention with the patient may be instituted prior to filling the
prescription.
[0050] As noted above, Figure 3is a flowchart illustrating the operations
performed by a
method, apparatus 20 and computer program product in accordance with one
embodiment of the
present invention. It will be understood that each block of the flowchart, and
combinations of
blocks in the flowchart, may be implemented by various means, such as
hardware, firmware,
processor, circuitry and/or other device associated with execution of software
including one or
more computer program instructions. For example, one or more of the procedures
described
above may be embodied by computer program instructions. In this regard, the
computer
program instructions which embody the procedures described above may be stored
by a memory
24 of an apparatus employing an embodiment of the present invention and
executed by
processing circuitry 22 of the apparatus. As will be appreciated, any such
computer program
instructions may be loaded onto a computer or other programmable apparatus
(e.g., hardware) to
produce a machine, such that the resulting computer or other programmable
apparatus provides
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for implementation of the functions specified in the flowchart blocks. These
computer program
instructions may also be stored in a non-transitory computer-readable storage
memory that may
direct a computer or other programmable apparatus to function in a particular
manner, such that
the instructions stored in the computer-readable storage memory produce an
article of
manufacture, the execution of which implements the function specified in the
flowchart blocks.
The computer program instructions may also be loaded onto a computer or other
programmable
apparatus to cause a series of operations to be performed on the computer or
other programmable
apparatus to produce a computer-implemented process such that the instructions
which execute
on the computer or other programmable apparatus provide operations for
implementing the
functions specified in the flowchart blocks. As such, the operations of Figure
3, when executed,
convert a computer or processing circuitry into a particular machine
configured to perform an
example embodiment of the present invention. Accordingly, the operations of
Figure 3 define an
algorithm for configuring a computer or processing circuitry, e.g., processor,
to perform an
example embodiment. In some cases, a general purpose computer may be provided
with an
instance of the processor which performs the algorithms of Figure 3 to
transform the general
purpose computer into a particular machine configured to perform an example
embodiment.
[0051] Accordingly, blocks of the flowchart support combinations of means
for performing
the specified functions and combinations of operations for performing the
specified functions. It
will also be understood that one or more blocks of the flowchart, and
combinations of blocks in
the flowchart, can be implemented by special purpose hardware-based computer
systems which
perform the specified functions, or combinations of special purpose hardware
and computer
instructions. In some embodiments, certain ones of the operations above may be
modified or
further amplified and additional optional operations may be included. It
should be appreciated
that each of the modifications, optional additions or amplifications below may
be included with
the operations above either alone or in combination with any others among the
features described
herein.
[0052] Many modifications and other embodiments of the inventions set forth
herein will
come to mind to one skilled in the art to which these inventions pertain
having the benefit of the
teachings presented in the foregoing descriptions and the associated drawings.
Therefore, it is to
be understood that the inventions are not to be limited to the specific
embodiments disclosed and
that modifications and other embodiments are intended to be included within
the scope of the
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. .
appended claims. Although specific terms are employed herein, they are used in
a generic and
descriptive sense only and not for purposes of limitation.
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