GLP-1 Prescribing Best Practices

Overview

Prescribing GLP-1 medications (e.g., Zepbound, Mounjaro) often involves complex fulfillment pathways, particularly when utilizing manufacturer-direct programs like LillyDirect. To ensure high fill rates and a seamless patient experience, we have compiled the following best practices based on our experience with high-volume weight management networks.

1. Critical Workflow: Pharmacy Selection

The Golden Rule: For manufacturer programs, using the correct selection method ensures the prescription routes through our specialized integration layer.

Scenario A: LillyDirect (Zepbound/Mounjaro Pens)

• Method: Use the Mail Order tab.
• Action: Select "FuzeRx" from the dropdown list.
• Do Not: Search for FuzeRx by address in the "Local Pickup" tab. The Mail Order selection ensures the correct routing logic is applied.

Scenario B: Zepbound Vials (Specific Form)

• Context: Zepbound Vials currently have limited fulfillment channels.
• Method: Use the Local Pickup tab.
• Action: You must search for and select one of the following:
  1. "Lilly Direct Self Pay" (Search by name/address).
  2. Any local Walmart pharmacy.
• Note: Sending vials to standard LillyDirect/FuzeRx via the mail-order tab may result in delays if they do not stock this specific form.

Scenario C: Novocare (Wegovy)

• Method 1 (Recommended): Send to Patient.
  • Select "Send to Patient" to allow them to choose their preferred pharmacy. Patients will see Novocare as a featured option alongside retail chains in their experience.
• Method 2 (Direct): Use the Mail Order tab.
  • Select "Novocare" from the dropdown list.

2. Clinical Precision: Medication Form & Sig

Fulfillment partners for GLP-1s utilize strict automated validation logic. A mismatch between the prescribed product and the available inventory will often trigger an immediate auto-rejection.

• Watchout - Form: Pay extremely close attention to the specific form selected (e.g., "Vial" vs. "Auto-injector Pen").
  • Note: We have seen instances where a prescription for a "Pen" was rejected because the partner only stocked "Vials," or vice versa.
• Watchout - Directions (Sig): Ensure instructions are clear and standard. Ambiguous directions can trigger a manual review on the pharmacy side, adding days to the fulfillment time.

3. The Patient Communication Journey

It is important to manage patient expectations regarding who will be contacting them.

• Multiple Sources: Patients may receive automated SMS or email communications from downstream fulfillment partners (e.g., Gift Health for LillyDirect) regarding order status, co-pays, or shipping.
• Guidance: Please advise patients that these communications are legitimate and part of the fulfillment process. If a patient receives a confusing error message from a third party, please request a screenshot so we can investigate with our partner.

4. Troubleshooting: "Rx Not Received"

If a patient or pharmacy reports that they do not have a record of the prescription, please follow this escalation protocol to ensure the fastest resolution:

1. Verify in Photon: First, check the order status in the Photon dashboard. If it shows "Sent" or "Received," the data has left our system.
2. Do Not Resend Immediately: Please avoid resending the prescription via a different method (e.g., fax or another EHR) immediately. This creates duplicate records and makes it harder to diagnose the root cause.
3. Escalate with Order ID: Send the specific Photon Order ID to [email protected]. We will inspect the transmission logs to pinpoint exactly where the handoff failed and resolve it directly with the pharmacy.

Summary Checklist for Providers

• Pharmacy: Selected specific partner via correct tab (e.g., FuzeRx via Mail Order for LillyDirect).
• Product: Verified correct Form (Vial vs. Pen).
• Directions: Verified clear, standard instructions.
• Issue: If an issue arises, grab the Order ID and escalate to [email protected] before resending.