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.