Pharmacologically rich clinical decision support provides extra measure for managed care success.

Gatekeepers are currently being asked to do more, including managing referrals to specialists. When a physician appropriately continues care at the primary level in order to pursue a more conservative course of treatment, prescription drugs often play an important role. According to the author, physicians can easily turn to utilization management, not disease management programs, for clinical guidance. Adding a pharmaceutical component with clear indications for drug use to the clinical decision support criteria or guidelines used by physicians helps them to decide when a trial of first-line pharmaceutical management is warranted and at what point to switch to an alternative drug therapy or to refer.