Clinical Requirements

Adherence to Evidence Based Medicine

  • AlphaScript has interfaces with the respective PBM’s and pulls the health risk management warning descriptions from the PBM’s to adhere to the treatment protocols and clinical guidelines to ensure appropriateness of treatment.

Generic Substitution

  • AlphaScript, in term of the provisions of the Agreement with the AlphaScript Network Providers can apply lawful substitution, as defined in the Medicine Act, in accordance with the Generic Reference Price of the medical scheme when rendering services to patients of such contracted medical scheme;
  • Alpha Script’ generic utilization, and hence the average cost per script and or per item, as evaluated by reputable PBM’s, is of the lowest, if not the lowest in the pharmacy segment in South Africa because of the increased generic utilization hence offering medical schemes optimal savings resultant in the improvement of their solvency levels.

Therapeutic Substitution

AlphaScript is willing and able to perform therapeutic substitution through its DUR Department subject to endorsement thereof by the medical scheme rules;

This form of substitution can be done on a:

  • retrospective basis ie all claims in the database bearing an undesirable premium priced product that can be substituted across therapeutic boundaries by a DUR pharmacist in consultation with the treating doctor; or
  • prospective basis in accordance with the benefit design at the point of script processing in a similar manner as described above.