Cypress Care

Clinical Rx™: A Healthier Return on Investment

At Cypress Care, we view drug utilization as one of the most important factors impacting pharmacy benefit management programs. As such, we have developed a variety of strategies that apply stringent clinical management and monitoring to produce maximum savings, while also addressing safety drivers and enhancing the quality of care for claimants.

Our complete drug utilization management solution is called Clinical Rx™. 

Clinical Rx™ includes:

ProDUR Rx™
Outreach Rx™
Precision Rx™
Monitor Rx™
CPA Rx™
CPRx™

Clinical Rx™ Suite of Services:

A clinically based, data-driven approach to cost-effective drug management.

Combining the medical expertise of our clinical pharmacists and advanced technology, Cypress Care has developed a comprehensive suite of utilization and formulary management programs that ensure appropriate utilization while reducing drug expenditures.

Our highly effective programs are both prospective and retrospective in nature and offer a strong line of defense against medical inappropriateness, excessive drug costs, fraud and abuse within workers’ compensation and auto claims.


ProDUR Rx™

Scrutinizes drug dispensing and medication cost at the point of sale

ProDUR Rx™ is your first line of defense against rising pharmacy costs. The clinical foundation of Cypress Care’s total pharmacy benefit management program, ProDUR Rx™ (Prospective Drug Utilization Review) evaluates drug utilization and appropriate dispensing at the point of sale. 

Based on pre-established criteria and compliance markers, ProDUR Rx automatically flags early refills, duplicate prescriptions and prescriptions filled by unauthorized physicians. The program also screens for drug interactions, supply limits and other utilization markers. Our system then searches for more cost-effective or appropriate prescription alternatives.


Outreach Rx™

Influences physicians’ prescribing habits and reduces drug expenditures

Cypress Care’s Outreach Rx™ program provides transparency into physicians’ prescribing habits.

Our clinical pharmacists send personalized letters to prescribing physicians, recommending less expensive, more appropriate drug therapies.

Goals of Outreach Rx:   

  • Start a dialogue about more appropriate treatment options
  • Suggest generic drugs when medically appropriate
  • Recommend more cost-effective drug regimens
  • Decrease or eliminate inappropriate off-label prescribing

Precision Rx™

Evaluates cost effectiveness of drug regimens through targeted medication therapy management

Through Cypress Care’s Precision Rx™ program, staff pharmacists review claims that include specific therapeutic classes of drugs that are used to treat certain chronic conditions.

This targeted medication therapy management program then provides for a consultative review of these drugs by a staff pharmacist to determine not only the right medications for the condition, but also the most cost-effective ones.

Our Precision Rx customers benefit from high conversion rates resulting in increased cost savings and ensuring that the most appropriate, lower cost drugs are being dispensed.

Monitor Rx™

Prevents abuse and ensures prescription adherence through scientifically valid drug screenings

A customizable drug monitoring and prescription adherence program, Monitor Rx helps pharmacists and physicians detect potential diversion, illicit drug use, medication misuse as well as fraud. If our clinical staff detects a potential problem with compliance, Monitor Rx drug urinalysis screenings are recommended.

Under the supervision of advanced-degree toxicology pharmacists, Cypress Care utilizes this state-of-the-art drug screening technology to monitor, detect and prevent drug abuse within our customer's pharmacy program.


CPA Rx™

Determines compensability and prevents inappropriate utilization through physician consultation

An early intervention program, the CPA Rx™ (Clinical Pharmacy Analysis) program uses physician-to-physician consultation to identify single drug therapies that are potentially inappropriate or non-compensable.

With our CPA Rx program, specialty-matched physicians, such as orthopedists, neurologists or pain management physicians are available for consultation to help Cypress Care to ensure that the patient is receiving the most appropriate drug regimen for their workers’ compensation or auto-specific injury.


CPRx™

Identifies potentially inappropriate medication profiles

With CPRx, Cypress Care’s clinical consultants review a claimant’s long-term medication therapy and engage in collegial discussions with the prescribing physicians in order to positively impact compliance and yield savings for our customers.

Customers who have used the CPRx™ program have experienced an 8:1 return on investment.