Pharma Assures Timely Government Benefits Delivery with NETSCOUT

Customer Profile

This leading pharmaceutical company provides wide-ranging health and pharmacy benefits management services to support both government and commercial insurance programs.

The company delivers point-of-sale (POS) pharmacy services under their own brand, while supporting customer scripts processing at other regional pharmacies. Their pharmacy benefit management services include benefit design consultation, drug-utilization review, and claims adjudication & processing services. With thousands of employees distributed throughout headquarters, data centers, call centers, and nationwide pharmacies, network and application availability is paramount for processing essential, patient-impacting prescriptions.

The Challenge

This pharmaceutical company plays a crucial role supporting a national program that provides government-subsidized pharmacy transactions for eligible recipients.

Under this government program, insureds are provided access to reduced-price prescription purchases at approved pharmacies across the country.

In these transactions, the pharmaceutical company serves as a processing intermediary between drug stores, insureds, and the government. The company aggregates sales and insurance coverage information collected at the POS and uploads it into back-end government systems. Approved transaction payments are routed from the government to the pharmacies themselves, with reconciliation also factoring the patient’s co-pay.

The pharmaceutical company’s network operations are based at two data centers, and they are critical for keeping the benefits program up and running. Any network latency that delays POS transactions can also jeopardize patients’ abilities to fill their prescriptions at agreed-to government rates. Some at-risk recipients may not possess the funds necessary to cover full-price purchases and end up going without a much-needed prescription, perhaps delaying pain relief or impacting overall health.

In the past, when network-impacting issues occurred, the company’s Network Engineering team used a post-event troubleshooting approach based on a legacy forensic packet capture tool. As this forensic tool approached end-of-life, Network Engineering saw an opportunity to improve their network monitoring approach and enhance benefits program service delivery efficiency.

Solution in Action

With its selection of NETSCOUT®, the company now assures network performance required for pharmaceutical program delivery by using the nGeniusONE Service Assurance platform. As part of this solution, the company has configured InfiniStream and nGenius 3900 Series packet flow switch technologies at the company’s data centers. The Network Engineering team is using the nGenius 3900 packet flow switches to aggregate the wire traffic from the network to the InfiniStream appliances.

Using the smart data generated by the patented NETSCOUT Adaptive Service Intelligence™ (ASI) technology in the InfiniStream appliances, Network Engineering employs nGeniusONE performance analytics to gain insights into network response time issues, troubleshooting, and post-event forensic analysis. As a result, Network Engineering now has visibility into the network traffic entering and exiting the data centers, which provides nGeniusONE views into service dependency maps, as well as network, application, and server performance data.

Staffed with numerous Cisco Certified Internetwork Experts (CCIEs), this Network Engineering team already knew the value of packet-based forensics. In moving from a reactive to proactive network monitoring approach, they now have a solution providing immediate, day-to-day troubleshooting of network issues, which has reduced their mean-time-to-repair activities.

The team quickly got a handle on using nGeniusONE Service Dashboard and Service Monitor views, and they are realizing the benefits of efficient troubleshooting “without the need to call 4-to-5 other” information technology (IT) resources to solve problems. This has allowed the company to transform to a proactive network monitoring solution using the new nGeniusONE solution, all without impacting their IT staffing profile.

The Results

With the company now proactively monitoring performance of the pharmacy program’s delivery network, benefit recipients can purchase their prescriptions for needed medications in a timely manner at their local drug store, all at the amount covered by their government benefits.

The company’s performance on this program has benefited the business commercially and internally. For example, the company’s performance has raised the profile of their brand with benefits recipients, pharmacies, and the government. As a result, the company has maintained their competitive edge, with additional government contract awards secured in part by their service delivery on the pharmacy program.

Internally, the company is cutting operating expenses by using NETSCOUT as their single vendor for network monitoring and packet flow switch technologies. Reducing the number of silo-specific tools has also contributed to maximized IT efficiency.