Career Path: Drug Utilization Review (DUR) Pharmacist – Council on Pharmacy Standards
CAREER SPOTLIGHT

Drug Utilization Review (DUR) Pharmacist

Use data analytics and clinical expertise to improve prescribing patterns and health outcomes for entire patient populations.

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The Strategist of Appropriate Medication Use

A Drug Utilization Review (DUR) Pharmacist works at a macro level, moving beyond individual prescriptions to analyze and influence the prescribing habits across a health system, health plan, or Pharmacy Benefit Manager (PBM). They are data-driven clinical experts who identify trends in medication use, such as over-utilization, under-utilization, and non-adherence. Their goal is to ensure that patients receive medications that are appropriate, medically necessary, and cost-effective.

As a DUR Pharmacist, you are a clinical investigator and an educator. You design and implement programs that guide physicians towards evidence-based prescribing. This includes developing clinical criteria for prior authorizations, performing retrospective reviews of claims data to find patterns, and creating educational materials for prescribers. Your work directly impacts patient safety and helps control healthcare costs on a large scale by promoting rational drug therapy.

Core Responsibilities

  • Retrospective Data Analysis

    Analyzing large sets of pharmacy claims data to identify prescribing patterns that deviate from clinical guidelines or best practices.

  • Clinical Criteria Development

    Creating and maintaining evidence-based criteria for drug utilization programs like prior authorization and step therapy.

  • Provider Outreach & Education

    Communicating with prescribers to discuss their prescribing patterns and provide education on appropriate medication use.

  • Program & Outcome Reporting

    Evaluating the clinical and financial impact of DUR programs and reporting the results to key stakeholders.

Your Certification Pathway to a Managed Care Expert

This analytical role requires a strong foundation in managed care principles, data analysis, and the pharmacy benefit landscape. These certifications demonstrate your readiness to excel in this specialized field.

CPBP

Certified Pharmacy Benefits Pharmacist

A crucial certification that validates your deep understanding of the PBM industry, benefit design, and formulary management.

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CPAP

Certified Pharmacy Analytics Pharmacist

Demonstrates your advanced skills in data analysis, interpretation, and reporting, which are core functions of the DUR role.

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CMCP

Certified Managed Care Pharmacist

Provides a broad foundation in all aspects of managed care pharmacy, including P&T committees, quality measures, and utilization management.

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A Day in the Life

Your day is a blend of deep data analysis at your desk and collaborative meetings to translate those findings into clinical policy.

Morning: Analyzing Opioid Prescribing Data

You run a query to identify members who are receiving opioid prescriptions from multiple prescribers. You analyze the data for high-risk patterns and flag several cases for intervention by the case management team.

Mid-Day: Developing New PA Criteria

You meet with a clinical team to draft new prior authorization criteria for a recently approved, high-cost medication for psoriasis, ensuring the criteria align with the latest clinical evidence and formulary strategy.

Afternoon: Provider Education Letter

Following a retrospective review that showed overuse of a certain class of antibiotics, you draft a letter to high-prescribing physicians, summarizing the findings and providing them with best-practice guidelines.

Ready to Impact Care on a Population Scale?

This analytical and influential career path allows you to leverage your clinical knowledge to improve the health and safety of thousands of patients at once.

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