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Pharmacy Clinical Programs

Appropriate, lower-cost drug use

Pharmacy Plan Designs | Pharmacy Delivery Options | Pharmacy Clinical Programs

We want to help your employees get the right drug at the right cost. The discounts we’ve negotiated with participating pharmacies help — as do our Aetna Rx Home Delivery® mail service pharmacy and Aetna Specialty Pharmacy® services.

But our drug utilization management and clinical evaluation programs really make a difference. One of our programs helped a national engineering and construction company control costs. Here are the nine-month results*:

Generic use increased from 43.5% to 46.7%
Per member per month costs decreased 36%
Total plan savings was $273,361 — 16% more than was expected over the course of one year.

Promote preferred drugs

Apply drug coverage checks

Spot potential prescription errors

Identify more than drug-to-drug

Based on the plan design you select, members can save money when they and their doctors choose drugs on our Preferred Drug List.

It can mean savings for you, too.

Pharmacy FAQs.

Our precertification and step therapy programs help us promote patient safety and appropriate drug use.

But they also help members and doctors consider other drugs that cost less and are just as effective. Learn more about our drug utilization review programs.

By analyzing pharmacy claims data, Aetna Rx Check^® can help uncover potential prescription errors or abuse.

We communicate these “opportunities to help improve care” to both doctors and members.

Powered by our patented CareEngine^® technology, Aetna MedQuery^® helps us find more than just drug-to-drug interactions.

We can also unearth drug-to-disease and drug-to-lab issues, and more.

We then communicate these opportunities to treating physicians.

*Does not guarantee similar results for any particular employer. Results vary by plan design and programs selected. Savings also depend on the drugs used by employees.

For complete information on plans and products, including availability, details, and brochures, please contact Aetna or your broker.