CarelonRx: Dispensing knowledge, compassion, and access to care

Featuring insights from Farrah Burk, Pharm.D

Every day, Farrah Burk, Pharm.D., advises patients on their medications and asks about their health status and needs. She is one of more than 400 pharmacists and pharmacy technicians who make up the Clinical Pharmacy Care team at CarelonRx, a division within the Carelon brand. They ensure patients have a full understanding of their disease states, medication regimes, goals of therapy, and the importance of taking medications to improve their health and quality of life.

A focus on people, not just prescriptions

Dr. Burk helps see that patients adhere to their drug regimens, take proper dosages, and effectively manage the safety and compatibility of multiple drugs. In collaboration with patients’ healthcare providers, she works to address issues they are experiencing with their medication therapy. She also makes sure vulnerable patients don’t fall through the cracks.

For example, Dr. Burk connects patients to resources to ensure they have transportation for medical appointments and to their pharmacy as well as for getting things needed for daily living such as home medication delivery, food and shelter resources, help with mental health needs, or follow-up care.

She recently helped an elderly patient named Ruth^*, who had just started insulin therapy. Ruth and her family were concerned that her diabetes wasn’t being effectively managed, despite her medication. Dr. Burk counseled Ruth on injecting her rapid-acting insulin, explaining blood sugar testing goals and proper dosing. But she also had a suspicion that Ruth’s meals might be negatively impacting her blood sugar levels.

Dr. Burk talked to Ruth about dietary choices, not just to help her better manage her diabetes and blood sugar levels, but because a healthy diet and nutrition are critical components of whole health. Ruth and her family were very appreciative of the support, and of having a designated pharmacist to reach out to for future concerns.

Beyond feel-good stories to real-world, lifesaving impact

As a pharmacy benefit manager (PBM), CarelonRx’s goal is to put the benefit back into pharmacy management to improve the health of the healthcare system. We provide clinical insights and innovative solutions to meet people where they are in their healthcare journeys. We go beyond traditional pharmacy services to ensure a person’s whole health.

For example, we perform drug utilization reviews (DUR) to evaluate and improve the prescribing, administration, and use of medications. The reviews help alert pharmacies and doctors of potential errors such as drug interactions, incorrect dosages, drug-disease issues, drug duplications, and potential drug misuse.

This is important because many patients have several doctors, and more than 40% use more than one pharmacy.¹ What’s more, that the FDA receives over 100,000 reports associated with medication errors every year.² PBMs like CarelonRx bring together information and technology to check for these errors.

That said, CarelonRx was built to work beyond the scope of a traditional PBM. As Paul Marchetti, CarelonRx President says, “What's different about CarelonRx is our focus on whole health and health equity. For example, a member who is taking specialty medications may also suffer from depression or be diabetic, which means that they need to be treated holistically. We organize our data and analytics along with our clinical programs to ensure that member gets their medication, but to also provide them with services from our behavioral health company and connectivity to providers. This allows us to close gaps in care and drive medication adherence.” 

Our team helps ensure that healthcare feels less complicated, more connected, and more compassionate. That means ensuring they have appropriate medical care, adopt healthy lifestyle choices, and take medications appropriately. And importantly, it means providing a reassuring, knowledgeable voice to help them along their healthcare and personal journeys.

*Name changed for privacy