Clinical program
SmartBlock: pay the right price.
Uncover the secret to smarter, more affordable prescriptions. Many combination products, compound kits and high-priced dermatologic items cost far more than their individual parts. SmartBlock stops your plan from paying that premium.
Get the SmartBlock one-sheetSmartBlock in one sentenceSmartBlock is MaxCare’s formulary safeguard that blocks expensive combination drugs and compound kits when the same components can be bought separately for less, or compounded at a local pharmacy for a minimal fee, while keeping effective lower-cost alternatives available to members.
The hidden cost
Has it ever crossed your mind that a prescription could be a blend of several drugs? Often that blend costs more than buying the individual components. Medications may be packaged as single products, masking the fact that they are combination or compound products, and your overall pharmacy benefit cost rises without warning.
Assessing the clinical evidence
Beyond the higher cost, published clinical evidence has failed to demonstrate that many combinations and compound kits work better than the individual products. You could be paying a much higher price for minimal or no advantage over lower-cost products available individually.
How it works
Introducing SmartBlock: cost-effective by design
SmartBlock targets specific expensive products whose components can be bought separately for less, or compounded for a minimal fee at a local pharmacy. Our clinical pharmacists developed the approach and keep updating it as new drugs meet the criteria.
Maximizing pharmacy benefits
Your money should go where it does the most for your members. We track pricing trends and build solutions that get you the best value while caring for your employees’ health.
Reviewing clinical evidence
We only block products where the evidence shows no clinical advantage over lower-cost individual components.
Reducing unnecessary costs
Continually updated by our clinical pharmacists, SmartBlock keeps affordable access to new market drugs while removing waste.
SmartBlock FAQ
What is SmartBlock?
SmartBlock is a MaxCare clinical program that excludes specific high-cost combination products, compound kits and certain high-priced dermatologic items from the formulary when their components can be bought separately for less, or compounded for a minimal fee at a local pharmacy.
Does SmartBlock limit access to effective treatment?
No. SmartBlock keeps effective, lower-priced alternatives available. Published clinical evidence has failed to show that many combination products and compound kits work better than their individual components.
How much can SmartBlock save?
In 2024, SmartBlock saved a current MaxCare client $147,000 on one drug for one patient.
Is SmartBlock kept up to date?
Yes. MaxCare’s clinical pharmacists developed SmartBlock and continually update it to cover new drugs that meet its criteria.
Related: all clinical services · Managing pharmacy costs: combination medications
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