Importance

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Abstract

Methods and systems for drug purchase validation are described. In an example embodiment, drug sale data is accessed from a prescription drug wholesaler regarding prescription drugs sold to the pharmacy by the prescription drug wholesaler during a period of time. A number of units of a prescription drug sold to the pharmacy are determined based on the drug sale data during the period of time. Pharmacy claims data over the period of time is accessed, where the pharmacy claims data reflects a plurality of adjudicated claims, and the plurality of adjudicated claims are a plurality of claims that were submitted for adjudication by the pharmacy during the period of time. A number of units of a prescription drug associated with the plurality of claims submitted during the period of time by the pharmacy for adjudication are determined based on the pharmacy claims data. The number of units of the prescription drug associated with the plurality of adjudicated claims that were submitted for adjudication by the pharmacy is compared with the number of units of the prescription drug sold to the pharmacy. A determination is then made as to whether a discrepancy exists based on the results of the comparison. Additional methods and systems are disclosed.

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First Claim