Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Formularies as Topic”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMed2004

Medicare proposal may benefit insurers.

The proposed guidelines from U.S. Pharmacopeial Convention Inc., which was assigned the task by last year's Medicare law, seek a middle ground between pharmaceutical companies and insurers. The USP proposal is expected to result in a final plan after the organization takes comments. It is also supposed to define a list of classes of drugs--more formally divided into therapeutic areas and pharmacologic subcategories.

Drug Industry↗
PubMed2005

Spillover effects of restrictive drug formularies: a case study of PacifiCare in California.

BACKGROUND: A restrictive drug formulary may influence how physicians treat other, unaffiliated patients, a phenomenon known as the "spillover effect." In a previous study we found significant spillover effects from Maine's Medicaid formulary. OBJECTIVE: To determine whether similar spillover effects exist for private insurers with less restrictive formularies and less dominant market presence. STUDY DESIGN: We treated PacifiCare's formulary changes for proton pump inhibitors (PPIs) as a natural experiment and studied whether these changes spilled onto non-PacifiCare patients in California. Rabeprazole and pantoprazole are the newly preferred PPI products. METHODS: We analyzed the physician-level before-and-after changes in prescribing of rabeprazole and pantoprazole for PacifiCare and non-PacifiCare patients. We also estimated the effect of PacifiCare share of practice on spillover effects using linear regressions. RESULTS: The number of rabeprazole and pantoprazole prescriptions increased simultaneously for non-PacifiCare patients and the increase was positively associated with PacifiCare share of practice. For non-PacifiCare prescriptions, a 10% increase in PacifiCare share of practice led to a 3.3% share increase for rabeprazole and a 1.6% share increase for pantoprazole, respectively (both P < .001). CONCLUSIONS: PacifiCare's PPI formulary changes generated significant spillover effects onto non-PacifiCare patients in California.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2005

The effect of access restrictions on the vintage of drugs used by Medicaid enrollees.

OBJECTIVE: To examine the extent to which recent Medicaid drug access restrictions, such as preferred drug lists (PDLs), may affect the vintage (or time since Food and Drug Administration approval) of 6 types of drugs used by Medicaid beneficiaries. STUDY DESIGN: Retrospective claims database analysis using National Drug Code pharmacy claims data. METHODS: A regression model was developed to analyze the effect that Medicaid access restrictions had on the vintage of medications prescribed in 6 different therapeutic categories. A "difference in differences" approach was used to compare the change in vintage of medications prescribed in Medicaid versus non-Medicaid patients between the January-June 2001 and July-December 2003 study periods. RESULTS: The results of the regression model showed that PDLs increased the age of Medicaid prescriptions by less than 1 year for drugs in 5 of the 6 therapeutic classes analyzed. In the case of pain management medications, the increase was more than 1.2 years. CONCLUSIONS: The results of the regression model suggest that Medicaid drug access restriction programs (e.g., PDLs) have resulted in an increase in the age of drugs prescribed for Medicaid beneficiaries versus non-Medicaid patients. Since previous research has suggested a clinical and economic advantage to utilizing newer versus older drugs, further research should be conducted to explore how these medication restriction policies may unduly affect Medicaid beneficiaries compared with privately insured patients.

Drug Prescriptions↗
PubMed2005

Physicians' prescribing responses to a restricted formulary: the impact of Medicaid preferred drug lists in Illinois and Louisiana.

OBJECTIVE: To determine the extent to which the strictness of the criteria used to control utilization of drugs not on a Medicaid preferred drug list (PDL) changes physician prescribing habits for non-Medicaid patients. STUDY DESIGN: Quasi-experimental design based on different timing of states' enactment of PDLs for cardiovascular medications. METHODS: A regression model was developed to analyze the effect that PDL implementation had on off-PDL product market share across 3 patient types (Medicaid, third-party insurance, and cash paying). The models included data from 2 states (Illinois and Louisiana) with different PDL prior-authorization criteria. The data allowed examination of different physician responses according to the proportion of Medicaid patients treated by the physician. The analysis also followed prescribing patterns longitudinally to determine whether the PDL-induced prescribing behaviors changed over time. RESULTS: There was a decrease of 9 percentage points (67.7%) and 6.2 percentage points (40.5%) in the Medicaid prescription share of restricted cardiovascular drugs post-PDL for Illinois and Louisiana, respectively. In the third-party insurance market, prescription shares of off-PDL drugs decreased 0.9 percentage points (6.8%) in Illinois and 1.3 percentage points (8.6%) in Louisiana. For physicians with a high percentage of prescriptions paid for by Medicaid, the share loss for off-PDL drugs was estimated to be more than 37% for the non-Medicaid portion of the practice. CONCLUSION: The effects of a Medicaid PDL on prescribing behavior extend beyond the Medicaid population. The health outcomes and economic consequences of these "spillover" effects are poorly understood and warrant further research.

Black or African American↗
PubMed2005

Exploring the potential link between Medicaid access restrictions, physician location, and health disparities.

OBJECTIVE: To determine whether a given doctor treating Medicaid patients is likely to practice in a predominantly minority area, and whether a minority patient is likely to be treated by a physician who is heavily influenced by Medicaid policy decisions. STUDY DESIGN: Retrospective pharmacy claims database analysis combined with zip-5-level demographic analysis. METHODS: Data extracted from a large prescription claims database were used to categorize all active prescribers in the United States by the proportion of prescription claims paid by state Medicaid programs from May 31, 2003, to April 30, 2004. US Census data from 2000 were used to assess the ethnic composition of each physician's zip code. Descriptive analyses were conducted to explore any associations between zip code racial composition and proportion of prescriber prescription claims adjudicated by state Medicaid programs. RESULTS: Physicians with more than 75% of their prescriptions adjudicated through Medicaid versus those with fewer than 1% of their prescriptions adjudicated through Medicaid practiced in zip codes that were 47% versus 24% nonwhite, respectively. Residents in Medicaid-intense zip codes were 59% nonwhite versus 31% nonwhite in the nation as a whole. CONCLUSION: Nonwhite residents are much more likely than white residents to live in a zip code where Medicaid prescribing rules will affect their physician. Any legislation-induced changes in prescribing patterns seem likely to disproportionately impact both Medicaid and non-Medicaid minority residents in these areas.

Drug Prescriptions↗
PubMed2005

Exploration of the impact of preferred drug lists on hospital and physician visits and the costs to Medicaid.

OBJECTIVE: To conduct an exploratory investigation of the possible effects of the implementation of a state Medicaid preferred drug list (PDL) on the average number of visits by Medicaid patients to hospitals and physicians, and to provide preliminary estimates of the Medicaid reimbursement costs of these additional visits. STUDY DESIGN: A regression-based, difference-in-differences retrospective analysis using anonymized patient-level data on cardiovascular-related inpatient and outpatient hospital visits and procedures, and physician visits and procedures. METHODS: The impact of the implementation of a state Medicaid PDL on a test group of Medicaid cardiovascular patients was examined. A contemporaneous group of non-Medicaid cardiovascular patients from the same state were used as controls. RESULTS: There was a statistically significant increase in the number of outpatient hospital visits and physician visits for the test group compared with the control group in the first 6 months after PDL implementation. There was a positive but statistically insignificant increase in the number of inpatient hospital visits. All increases in visits for the test group compared with the control group in the second 6 months after PDL implementation were positive but statistically insignificant. As a result, estimated average Medicaid reimbursement costs for cardiovascular patients in the state increased during that year. CONCLUSION: The observed range of increases in hospital and physician visits is evidence for the possible existence of an unintended consequence of PDL implementation by state Medicaid programs. Precautionary research in this area is clearly called for.

Adult↗
PubMedDate not supplied

Confusing brand names: nightmare of medical profession.

OBJECTIVE: India has more than 20,000 registered pharmaceutical manufacturers. Consequently, there is a flood of brand names to choose from. We conducted this study to analyse and sort out the multitudinous brand names thronging the Indian market, and identified those that could create a possible confusion. MATERIALS AND METHODS: Recent issues of drug formularies like Indian Drug Review, Drug Index, and Monthly Index of Medical Specialities-India were checked and all the brand names given were included. Some other brand names that are available with the pharmacists but are not included in these indexes were also included in the study for analysis. OBSERVATIONS: Potentially confusing brand names were sorted out and categorised according to the severity of damage they can cause if misinterpreted by the pharmacist or the patient. Subgroups were made according to the brand name, the generic name, and the manufacturers of the drug. CONCLUSION: Several brand names are strikingly identical, similar looking (orthographic), or similar sounding (phonological). Preventing this possible confusion is not the work of any one person involved. We describe the role of prescribing doctors, dispensing pharmacists, consumer patients, and the manufacturing companies to prevent "wrong prescribing" due to similarities in brand names.

Drug Industry↗
PubMed2005

Impact of the Medicare prescription drug benefit on home- and community-based services waiver programs.

"Dual eligibles" is the term for the 6.4 million low-income, elderly, and disabled Americans who are enrolled in both Medicare and Medicaid. With home-and community-based services waivers allowed under Section 1915(c) of the Social Security Act, many of these individuals are able to live in a home or community setting, thereby avoiding institutionalization. Surveying Maryland's 3,180 dual eligibles who are enrolled in home-and community-based waiver programs, the author finds that the end-of-2005 transfer of prescription drug coverage from Medicaid to Medicare under the Medicare Modernization Act of 2003 could put these beneficiaries in jeopardy. Maryland's experience is likely to be typical of what other states will face. The author recommends a number of federal policy remedies, among them allowing 90-day prescriptions, using open or shared formularies, and lengthening the enrollment period.

Aged↗