Drug utilization review (DUR)
Drug utilization review (DUR) is the structured check of a prescription against the patient’s history and clinical criteria — screening for interactions, duplications, contraindications, and misuse before and after dispensing.
- Screens prescriptions for interactions, duplications, and contraindications
- Prospective (before dispensing) and retrospective (pattern analysis)
- Pharmacists resolve DUR flags before filling
- Distinct from PDMP checks, which cover controlled-substance history
Prospective and retrospective review
Prospective DUR happens before the drug reaches the patient: the prescriber’s e-prescribing system and the pharmacist’s dispensing system both screen for drug–drug interactions, allergies, therapeutic duplication, and dosing outliers, and the pharmacist resolves flags before filling. Retrospective DUR looks at patterns after the fact — plans and PBMs mining claims for overuse, gaps, and prescriber outliers. State Medicaid programs are legally required to run both.
DUR in a telehealth program
In DTC care the prospective layer is where quality lives: complete medication and allergy capture at intake is what makes the screens meaningful, and a program whose intake feeds clean data into eRx gets interaction checking effectively for free. The failure mode is garbage-in — an intake that skips current medications produces a DUR pass that means nothing. This is also distinct from PDMP checks, which query a state’s controlled-substance dispensing history and are separately mandated.
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Who performs DUR?
Layered actors: prescribing software at the point of care, the dispensing pharmacist (a legal duty), and plans or PBMs retrospectively.
Does DUR replace clinician judgment?
No — it surfaces flags. The prescriber and pharmacist decide what a flag means for the specific patient.
What makes DUR effective in telehealth?
Intake quality. Complete medication and allergy history captured at signup is what turns automated screening into real safety.