A point-of-sale safety alert is a screening tool to alert pharmacists of potential drug safety issues during prescription processing.
For example, Medi-Cal fee-for-service's last update included having point-of-sale safety alerts focus on central nervous system (CNS) polypharmacy. During prescription processing, pharmacists receive alerts when patients reach a threshold of four active prescriptions within the following therapeutic categories: opioid pain or cough medications, benzodiazepines, skeletal muscle relaxants, sleep drugs and tranquilizers (non-benzodiazepine), antipsychotic medications, and other selected psychotropic medications with CNS depressant properties.
L.A. Care also has point-of-sale safety alerts. During prescription processing pharmacists receive safety alerts for: drug-drug interactions, low and high doses, under and over utilization, therapeutic duplication, high morphine milligram equivalents, and other safety issues.
L.A. Care has additional prescription drug safety programs. Prescribers are sent a letter notifying them when a member's prescriptions meet specific safety thresholds for dose, drug combination or use. These programs include:
- Multiprescriber — Patients with 7 or more unique prescribers per month in 2 of 4 months
- Controlled Substance Monitoring (CSM) + Repeat Alert — Patients with 9 or more controlled substances + Prescribers + Pharmacies in 2 out of 4 months
- Duplicate Therapy — Patients with 2 or more prescriptions in the same drug class consistently during a 4 month look back period
- Triple Threat + Repeat Alert — Patients with prescriptions for each of the following drug classes: opioids, muscle relaxants, and benzodiazepines/sleep aids in a month for 2 of 4 months
- Multi-Prescription — Patients received 13 or more prescriptions per month in previous 3 of 4 months
- Expanded Fraud Waste & Abuse — Patient with 7 or more prescriptions with abuse potential + Prescribers + Pharmacies per month for 2 of 4 months
L.A. Care encourages providers who receive safety alerts and notifications to:
1. Review the alert/notification.
2. Take action if warranted to optimize the drug regimen of each patient based on your professional judgement.
View the Medi-Cal ProDUR Update: Additive Toxicity Alert Now Focused Only On CNS Depressants.