Definitions for "Drug Utilization Review"
A method for evaluating or reviewing the use of drugs in order to determine the appropriateness of the drug therapy.
complex manage care process that occurs as part of the reimbursement process. A review conducted before the drug is dispensed by the pharmacy or administered by the physician is a pre-authorization review. A review conducted afterward is a retrospective review. A failure to pass either type of review will result in a failure to secure drug reimbursement. Some aspects of drug utilization review are designed to protect patients from dangerous reactions to medications. For example, one aspect of the review process seeks to protect patients from drug-to-drug interactions. Other aspects seek to make sure that doctors follow specific prescribing guidelines for specific diseases. The drug utilization review process can also be used as a way for health plans to avoid - or at least delay - having to pay for an expensive drug a doctor wants to use or prescribe. When doctors and patients have access to the right information, they can work most effectively with health plans on a level-playing field - making what is good about drug utilization review work for everybody.
An evaluation of prescribing patterns or targeted drug use to specifically determine the appropriateness of drug therapy.