The retrospective drug use review program must use: (1) Guidelines established by the Oregon Health Authority that are based on the recommendations of the Pharmacy and Therapeutics Committee; and (2) The mechanized drug claims processing and information retrieval system to analyze claims data on drug use against explicit predetermined standards that are based on compendia and other sources to monitor the following: (a) Therapeutic appropriateness. (b) Overutilization or underutilization. (c) Fraud and abuse. (d) Therapeutic duplication. (e) Drug-disease contraindications. (f) Drug-drug interactions. (g) Incorrect drug dosage or duration of drug treatment. (h) Clinical abuse and misuse. Note: See note under 414.351.
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