DUR Types
| DUR Type | When | What It Identifies | Action |
|---|---|---|---|
| Prospective | Before dispensing | Drug interactions, contraindications, duplicate therapy | Alert pharmacist; require PA |
| Concurrent | During therapy | Adherence gaps, dose changes, new interactions | Outreach to patient and prescriber |
| Retrospective | After dispensing | Patterns of inappropriate use, fraud, waste | Prescriber education; PA requirement |
Prospective DUR
Prospective DUR reviews prescriptions before dispensing — catching drug interactions, contraindications, and duplicate therapy before the patient receives the drug. Prospective DUR is performed by the dispensing pharmacist and the PBM's clinical system. Prospective DUR alerts are generated when a new prescription conflicts with the patient's existing medications or medical history.
Retrospective DUR Value
IQ Insight
Retrospective DUR — analyzing claims data to identify patterns of inappropriate drug use — is a powerful tool for identifying fraud, waste, and abuse. Common retrospective DUR findings: (1) patients receiving opioids from multiple prescribers; (2) prescribers with unusually high rates of high-cost drug prescribing; and (3) patients receiving drugs that are contraindicated for their age or gender. Retrospective DUR findings should trigger prescriber education and, in severe cases, PA requirements.