Page 26 - FPGEE Management Q&A Book

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Examples of disease-specific instruments: 17. (a) The one-time transfer of the original
prescription information for a controlled substance
1. Arthritis Impact Measurement Scale (AIMS) listed in Schedules III, IV, or V, if any authorized
2. Asthma Quality of Life Questionnaires (AQLQ) refills remain, for the purpose of dispensing is
3. Diabetes Quality of Life (DQOL) permissible between pharmacies within six (6)
4. Functional Living Index Cancer (FLIC) months from the date the prescription was issued.
5. Quality Of Life In Epilepsy (QOLIE)
6. HIV Overview of Problems-Evaluation System However, pharmacies electronically sharing a real-
(HOPES) time, on-line database may transfer up to the
maximum refills permitted by law and the
2. Generic/General Instrument: As the name prescriber's authorization.
suggests, general instruments put more emphasis
on all conditions that have a general effect on the 18. (a, b and c) The principal components of
quality of life. The general/generic instruments Pharmacy Benefit Management (PBM) program are:
provide a better picture of a disease or condition.
1. A legally enforceable benefit design contract that
The KDQOL (Kidney Disease Quality Of Life) is the outlines covered and excluded benefits.
perfect example of a general/generic instrument,
and it can be further explained by learning profile 2. A defined physician provider network under the
and utility-based instruments. contract with the health plan.

15.(b) I and II only. Cost-Utility Analysis: It is 3. A defined pharmacy provider network under the
defined as a method where costs are measured in contract with the health plan or PBM.
terms of dollar amounts and consequences are
measured in terms of quality of life. 4. A community pharmacy network with the point-
of-sale (POS) computer adjudication system.
Cost-effective analyses and cost-utility analyses are
almost same; the only difference between them is 5. A drug formulary.
the unit of consequences or therapeutic outcomes.
The former measures the outcomes in natural units 6. A mandatory generic substitution program.
(e.g. reduction in blood pressure or cholesterol);
while the latter relies on quantity-adjusted life gain 7. Pharmaceutical manufacturer discounts or
years. rebates.

Cost-Utility Ratio: Costs($)/Utilities (e.g. QALY, 8. A patient prescription co-payment.
Quality Adjusted Life Years) QALY is the number of
years at full health compared to the number of 9. Retrospective drug utilization review (DUR).
years of illness. A year of perfect health would be
calculated as 1.0 measured on QALY, and death 10. Drug formulary conversion.
would equal 0.
11. Compliance improvement.
For example, six years of perfect health would be
counted as 6.0 QALY, whereas six years of living 12. Disease management program.
with cancer, with each year having a utility of 0.4,
would be valued at 2.4 QALY. 19.(d) All. Each protocol developed, pursuant to the
collaborative drug therapy management
16.(b) Schedule V prescription controlled drugs can agreement, shall contain detailed direction
be refilled 5 times. concerning the actions that the pharmacist may

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