Formulary guidance and transparency from P&T to point of care

MMIT Policy & Restriction Analytics Release on September 28th

Posted by Stu Allen on Sep 29, 2015

MMIT is committed to regularly enhancing its products – both our data and our software.  Our most recent release is available to clients who license our Policy and Restriction module (formerly Specialty Analytics) and features:

Easier Navigation: We have redesigned the menu structure within Analytics to allow a clear choice of either Pharmacy Benefit or Medical Benefit as a navigation path.  This should eliminate the confusion from the current options of Formulary and Specialty, which has been removed.  The Prior Authorization (PA) and Step Therapy (ST) views, previously available under Specialty, have been reorganized under the Pharmacy Benefit->View dropdown, since both relate to Pharmacy Benefit coverage.  We have moved the Medical View, also previously available under Specialty underneath the Medical Benefit->View dropdown, so users can now see the medical criteria independently and clearly.

Addition of Medical Lives: We have incorporated medical lives into all of the Medical Benefit views. Now, anytime you are exclusively looking at Medical coverage information, the data will be based off of Medical lives as opposed to Pharmacy lives.

Enhanced Step Assessment for Generics: We have expanded our Step Therapy data, so that we now call out the names, number and types of generics required in a given step statement. The previous Yes/No Generic column, available in the Step Details view, will be replaced by a # Generics column.  As we assess restrictions on generic drugs’ step information, this new column will represent the minimum number of generic steps required.  We will also now include names of generics or types of generics required for prior failure.

Fine Tuning the Medical Slice on Pharmacy Benefit Graphs: Because we now provide a separate view for Medical coverage information, we have removed the Medical slice from the Pharmacy Benefit view of restrictions. If a product’s coverage exists solely under the Medical Benefit, then we will represent the product as being Not Covered under the Pharmacy Benefit.  Going forward, the Pharmacy Benefit coverage view will relate only to coverage on a given patient’s pharmacy benefit, and the Medical Benefit view will relate solely to medical coverage.

Updating the Data in Formulary Status column: To better represent formulary coverage on the detailed ST, PA, and Medical screens, we will be updating the status type that shows in the Formulary Status column to show Universal/Unified status. This will replace the current representation of formulary Raw status.

To get more information or assistance with the change, contact MMIT support at

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Topics: Product Release

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