Pharmacy Benefit Management (PBM)

PBM is comprehensive drug utilization program offered by WAPMED to its members to manage health insurance pharmaceuticals benefit in line with best medical practices.

WAPMED is associated with MedImpact Arabia / Dimensions Healthcare for the eRx/PBM services as part of the regulatory compliance as mandated by the Dubai Health Authority and manages its PBM program via internet-based interface between WAPMED and pharmacies within WAPMED’s network in Abu Dhabi & Dubai.

PBM involves a wide range of real time controls such as:

  • Drug Indication – checks on prescribed drugs for consistency with diagnosis.
  • Drug dosage & refill frequency.
  • Drug Age & Gender compatibility
  • Drug Allergy.
  • Drug Contraindication/Interactions – possible negative drug-to-drug interactions and drug-to-diagnosis contraindications to avoid possible health hazards.
  • Drug Duplication – The checks are performed on prescription history available in our database.
  • Insurance Coverage – checks such as drug coverage, benefits and plan limits and any other factors relevant to the plan.
  • Actively monitoring prescription claims for fraud and abuse.