The Pharmacy Audit: What Is It and Are You Prepared?

Abstract

Pharmaceutical expenditures in the United States, estimated to be in the billions, increased by 14.2% in 1997. I This growth, largely attributed to increased pharmaceutical utilization and newly patented pharmaceuticals that lack generic competition, will more than likely continue. This trend, coupled with the fact that 70% of all prescriptions are covered partially or fully by a third-party payor, I has resulted in increased scrutiny of pharmaceutical dispensing and reimbursement processes. The audit process is one means of reviewing pharmacy programs; it ensures that procedures and reimbursement mechanisms are consistent with contractual and regulatory requirements. This article presents an overview of the audit