Systems and methods for proactive identification of formulary change impacts

A system for identifying impacts of a proposed modification to a formulary, the system comprising:

• at least one hardware processor;
• and
• at least one executable software module that, when executed by the at least one hardware processor,
• receives a proposed modification to a formulary from a user,
• in response to receiving the proposed modification to the formulary,
• accesses one or more data sources,
• determines an impact of the proposed modification to the formulary based on the one or more data sources, and
• automatically identifies one or more alternative modifications to the formulary that achieve a same or similar objective as the proposed modification with less impact than the proposed modification,
• provides the impact of the proposed modification to a user, along with the one or more alternative modifications, prior to implementation of the proposed modification,
• receives either an approval or disapproval of at least one modification to the formulary, from among the proposed modification and one or more alternative modifications, from the user, and,
• when an approval of at least one modification is received from the user, makes the approved at least one modification to the formulary, and initiates a communication to each of a plurality of members of a prescription plan that have been affected by the approved at least one modification to the formulary.

A computer-implemented method for optimizing a formulary, the method comprising, by at least one hardware processor:

• receiving a plurality of criteria, wherein the plurality of criteria are weighted;
• accessing one or more data sources;
• identifying a plurality of potential modifications to the formulary;
• determining one or more impacts of the plurality of potential modifications to the formulary based on the one or more data sources;
• determining an optimal set of the plurality of potential modifications based on the plurality of criteria, wherein adherence to at least one of the plurality of criteria is given more weight than adherence to at least another one of the plurality of criteria;
• providing the optimal set of the plurality of potential modifications to a user;
• receiving either an approval or disapproval of the optimal set of the plurality of potential modifications;
• and,
• when an approval of the optimal set of the plurality of potential modifications is received, making each potential modification, from the optimal set of the plurality of potential modifications, to the formulary, and initiating a communication to each of a plurality of members of a prescription plan that have been affected by the optimal set of the plurality of potential modifications.