Manufacturers that prescribe products with the potential for diversion and abuse, such as opioids, have a responsibility to “know their customer” — to monitor the prescribing patterns of healthcare providers (HCPs), investigate HCPs with at-risk behaviors, and adjust calling plans and field sales force activities accordingly.

QPharma, a leading provider of compliance solutions to the highly regulated pharmaceutical and life sciences industries, is a trusted partner to companies requiring risk monitoring and diversion detection support. We use Ti Risk, part of the Titanium® family of analytics and compliance tools, to analyze claims data, patient data, and prescribing patterns for physicians — and their peer networks — on a monthly and quarterly basis.

We evaluate and score HCPs based on their behaviors and, uniquely, the aggregate behavior of their patients. Specifically, we use patient-level claims data to identify patients who have suspicious prescription signatures, such as those who have obtained prescriptions from unusually large numbers of HCPs in many different locations. We identify the HCPs who are servicing unusually large numbers of such patients and are thus at risk of being perceived as non-compliant. HCPs in the highest risk category are subject to further research by QPharma and investigation by the client. Based on these investigations, the client can then adjust and optimize their sales force activities to ensure that they are calling on the most responsible, ethical, and engaged prescribers.

Call Plan Count

  • Number of HCPs in Call Plan
  • Breakout based on Risk Score
  • Breakout will be 75 and above, and 74 and below
  • Each HCP has a profile that contains first name, last name, address, designation, SLN, Risk Score, and research tab
  • Each profile will have the ability to move HCP between queues


  • All HCPs in call plan with Risk Score of 75 or higher are automatically moved into the research queue
  • QPharma conducts research and inputs findings directly into each HCP’s profile
  • QPharma reviews research with the client to determine escalation


  • Client investigates all HCPs placed in the Escalate queue
  • Once client begins investigation, HCP moves to the Under Investigation queue

Under Investigation

  • Client conducts internal investigation and makes determination for next steps and sales force call plan
  • QPharma can provide full consultative support throughout the investigation


  • Upon completion of investigation, client marks the investigation closed and selects a final disposition

To learn more about our HCP Risk Monitoring and Diversion Detection, please contact us.