How to Address Polypharmacy Concerns: Clinical Reviews

Polypharmacy is the concurrent use of multiple drugs (usually 5+) to treat multiple diseases and health conditions. It can often lead to safety concerns, particularly with older adults. Multiple medications can be difficult to manage and keep track of, can be expensive, and can leave the patient at an increased risk of adverse reactions and drug interactions, particularly if the patient is being prescribed different medications by different health care providers with no oversight in place.

This is why a robust clinical review program is essential to an Rx program. A pharmacy and therapeutics committee, comprised of pharmacists and doctors both internal and external to the PBM, meets periodically to evaluate whether drugs meet certain criteria to place them on a clinical review list. Included in this evaluation is whether the drug can have dangerous side effects when combined with another medication.

The CDC reports that two thirds of U.S. adults between the ages of 40 and 79 used one or more prescription drugs in the prior month, and 22% used five or more, putting them the most at risk for experiencing adverse drug effects due to inappropriate polypharmacy. Side effects can include cognitive impairment, falls, and drug-disease interactions—i.e. when a drug prescribed to address one condition worsens another or even creates a new issue. The unsupervised interaction of multiple drugs can have devastating consequences: over 750 people aged 65+ are hospitalized every day for an adverse drug event from one or more medications.2 

Clinical review acts as a safeguard to ensure that the drug(s) prescribed and dispensed to members are used:

• In accordance with the Food and Drug Administration’s (FDA) approved uses(s)
• In accordance with the pharmaceutical manufacturer’s drug label directives and recommended uses/dosages
• In a way that the member has no contraindications to other medications they may be using

Benecard Services uses our clinical review program to ensure member health and safety. Click here to learn more about Benecard Services and click here to read more about clinical reviews.