Pharmacy Benefit Management (PBM)

MediKredit’s Pharmaceutical Benefit Management (PBM) service, coupled with our integrated chronic medicine management programme, provides healthcare funder beneficiaries with access to clinically appropriate, cost-effective treatment.

This in turn ensures that expenditure on medicines is strictly managed to avoid unnecessary costs and/or utilisation for healthcare funder clients, including medical schemes, and their valued beneficiaries.

Key components of our PBM service include:

  • Development and maintenance of evidence-based protocols
  • Pharmacy Advised Therapy (PAT) and acute medicines management
  • Pre-authorisation and Drug Utilisation Review (DUR) for chronic and high-cost medicines
  • PBM application on medicine claims adjudication and management
  • Reporting on a medical scheme’s performance related to PBM services
  • Prescribed Minimum Benefit (PMB) compliance and management
  • Flexible and customisable generic and therapeutic reference pricing systems