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At least 1,009 records · Page 56Linked to original sources
PubMed2002

How effectively do managed care organizations influence prescribing and dispensing decisions?

OBJECTIVE: To examine the extent to which managed care organizations (MCOs) use formularies, therapeutic interchange, and prior approval and to determine how effectively these tools influence prescribing and dispensing decisions. RESEARCH DESIGN: Literature review. PATIENTS AND METHODS: Studies relating to effectiveness were identified through a comprehensive literature review using the MEDLINE and International Pharmaceutical Abstracts databases. Only peer-reviewed studies done in outpatient settings were included. Studies measuring extent of use were taken primarily from published and widely available marketing research reports. RESULTS: Closed formularies were found to be effective in decreasing the utilization, but not necessarily the cost, of prescription drugs. Just under half of health maintenance organizations (HMOs) and 10% of employer-sponsored health plans use closed formularies. Prior approval programs have been shown to reduce use of target drugs and drug costs in a small number of drug classes. Nearly all HMOs and most employer-sponsored health plans use prior approval programs. How extensively the programs are used is not reported. About half of HMOs and employer-sponsored health plans use therapeutic interchange. Voluntary programs have been shown to be successful in staff-model HMOs. Mandatory, but not voluntary, programs have been shown to be successful in independent practice association-model HMOs. CONCLUSION: The literature indicates that most MCOs have had limited success using formularies, therapeutic interchange, and prior approval to influence prescribing and dispensing decisions. Although these tools have been effective in some situations, their impact has been limited by their low rate of utilization.

Cost Control↗
PubMed2002

[Evaluation of reimbursement applications for new drugs].

BACKGROUND: It has been suggested that decisions about which drugs should be reimbursed by the Norwegian National Insurance Administration (NIA) are ad hoc and made without explicit criteria for evaluating applications. MATERIAL AND METHODS: We assessed all documents that we were able to retrieve from the NIA for a sample of 31 applications to add new drugs to the drug benefit program, mainly in the 1990s. The assessment was done with respect to two questions. First, to what extent were different factors explicitly evaluated, such as treatment effects, side effects, cost-effectiveness and reimbursement costs? Second, to what extent did these factors affect the decisions that were made? RESULTS: We found documents for 19 of the 31 drugs. For the 19 drugs and nine factors that we considered as potentially important in making a decision (a total of 19 x 9 = 171 possible assessments), we found a total of only eight explicit written evaluations. In 10 out of 19 cases costs to the NIA and control of these costs, or use of the drug, appeared to have an important impact on the decision that was reached. INTERPRETATION: Based on the documents to which we have had access, the NIA's evaluations have not been systematic or transparent for the vast majority of drugs.

Cost-Benefit Analysis↗
PubMed2003

Developing an effective generic prescription drug program.

Pharmacy benefit managers (PBMs) use a variety of pricing strategies. When employers have a thorough knowledge of those strategies, they can use them to their advantage to help manage pharmacy benefits. This article discusses PBM strategies in terms of what employers need to know, the questions employers need to ask and goals employers must keep in mind in order to secure the affordable cost and quality prescription drug management programs that they and their employees need and deserve.

Cost Savings↗
PubMed2002

[Collation and research on the different texts in Qian jin yao fang (Precious essential formulary, PEF)].

There is considerable difference in the texts between PEF and the archaic editions Sun zhen ren qian jin fang (The Immortal Sun's Precious Formulary, ISPF) and the Song - revised edition Bei ji qian jin yao fang (Precious Essential Formulary for Emergency, PEFE). It is hoped that the real features of PEF can be worked out through collated studies on these two editions so as to offer a basis for systematic research on PEF. At the same time, it has been proved that during the revision and collation of PEF by the Song scholars, it is certain that dramatic revisions had been made on its medical materials, especially an abundant amount of medical materials were added. As a result, the current circulated edition of PEFE does have obvious differences with Sun's original work, while ISPF, in contrast, preserves the original features of Sun Simiao. Hence, ISPF is of important academic significance in the in - depth study of PEF.

China↗
PubMed2003

Attitudes of physicians toward formularies and services provided by pharmacists.

This study was undertaken to evaluate the attitudes of physicians toward formularies as well as services provided by the pharmacy department in a large integrated delivery system (IDS) with a multispecialty group practice. Surveys were sent to all 282 practitioners in the IDS, requesting information on their use of and satisfaction with the existing printed "Formulary Quick List" (FQL), their satisfaction with pharmacy services, and their attitudes toward formularies in general. A five-point rating scale was used. The response rate was 32%, with the majority from staff physicians. Results indicated that practitioners were very satisfied with the services offered by the pharmacists. Their attitudes toward the FQL were very positive. However, their attitudes toward formularies in general were very negative. There was a significant, negative correlation between attitudes toward formularies in general and attitudes toward pharmacy services, as well as toward the FQL.

Attitude of Health Personnel↗