US 12,243,630 B2
Drug alternative recommendation engine for real-time prescription benefit requests
Amit K. Bothra, Wildwood, MO (US); Aanal Patel, Bridgewater, NJ (US); Daniel C. Casper, Ellisville, MO (US); Pritesh J. Shah, Paramus, NJ (US); Jonelle Lofton, Florissant, MO (US); John J. Felo, II, Pipersville, PA (US); and Gaspar Reyes, Grapevine, TX (US)
Assigned to Evernorth Strategic Development, Inc., St. Louis, MO (US)
Filed by Evernorth Strategic Development, Inc., St. Louis, MO (US)
Filed on Feb. 22, 2022, as Appl. No. 17/677,319.
Prior Publication US 2023/0268044 A1, Aug. 24, 2023
Int. Cl. G16H 20/10 (2018.01); G06Q 40/08 (2012.01)
CPC G16H 20/10 (2018.01) [G06Q 40/08 (2013.01)] 18 Claims
OG exemplary drawing
 
1. A system for identifying one or more alternative drugs responsive to a prescription benefits request, the system comprising:
a processor in communication with a memory including instructions that, when executed by the processor, cause the processor to:
receive a prescription benefit request, the prescription benefit request indicating at least a requested drug and a patient identifier;
identify, in a first database, one or more covered alternative drugs based on the requested drug and a drug coverage plan associated with the patient identifier;
identify, in a second database, one or more additional alternative drugs based on at least one of the requested drug and at least one covered alternative drug of the one or more covered alternative drugs;
determine, based on the covered drug plan associated with the patient identifier, whether the one or more additional alternative drugs includes at least one covered additional alternative drug;
in response to a determination that the one or more additional alternative drugs includes at least one covered additional alternative drug, determine, for each of the at least one covered additional alternative drug and the one or more covered alternative drugs, an alternative drug value;
identify the at least one covered additional alternative drug and the one or more covered alternative drugs having a lowest alternative drug value;
rank the at least one covered additional alternative drug and the one or more covered alternative drugs having the lowest alternative drug value based on number of times each of the at least one covered additional alternative drug and the one or more covered alternative drugs having the lowest alternative drug value has been filled for an associated prescription;
generate a request response indicating at least the alternative drug of the at least one covered additional alternative drug and the one or more covered alternative drugs having the lowest alternative drug value ordered according to the rank; and
communicate an order associated with a prescription request to fill the alternative drug to an order processing device associated with a high-volume pharmacy; and
a pharmacy fulfillment device that:
receives, from the order processing device, instructions to fulfill the order;
identifies a puck having dimensions corresponding to a prescription container of the order;
controls at least one robotic arm to position the puck on a pallet;
controls a loading device to load the prescription container into the puck; and
controls at least one dispensing device to fulfill the order.