Systemwide Effects of Medicaid Retrospective Drug Utilization Review Programs

Abstract

Aggregate pooled cross-sectional and time-series annual state data for 1985 to 1992 were used to estimate the systemwide effects of retrospective drug utilization review programs (Retro-DUR) on Medicaid drug and nondrug outcomes. The results provide evidence that these programs produce significant cost savings in the drug budget without spillover effects (positive or negative) in other nondrug budgets within the Medicaid system. We also examine the influence of restricted formularies in this post-Retro-DUR era on drug and nondrug budgets in the Medicaid system; we find significant cost savings in the former but positive spillover effects in the latter.

Topical Corticosteroid Prescribing Patterns following Changes in Drug Benefit Status

“…The Annals of Pharmacotherapy ■ 2003 June, Volume 37 ■ 791 www.theannals.com Both qualitative and quantitative studies on the effect of formularies, including effect on changes in prescribing patterns and patient health outcomes, are needed. [26][27][28][29] Future work would include examining the concurrent prescribing of both a topical corticosteroid and topical antifungal/antibiotic. The reason for the increase of the potent topical corticosteroids needs to be further examined.…”

Exploring the Link between Ambulatory Care and Avoidable Hospitalizations at the Veteran Health Administration

“…Their findings indicated a strong substitute relationship between prescription drugs and physician and inpatient mental health services. Their updated results examining pharmaceutical drug cost‐containment policies on physician and inpatient services in the Medicaid program (Moore, Gutermuth, & Pracht, 2000) supported earlier findings.…”

Effect of 6 Managed Care Pharmacy Tools: A Review of the Literature

“…Using aggregated state Medicaid data, Moore et al (2000) found no significant differences in prescriptions per recipient, the number of drug recipients, or average prescription cost between states with or without a retrospective DUR between 1985 and 1992. 56 However, drug expenditures per recipient and total drug expenditures were 4.9% and 6.5% lower, respectively, in states with DUR programs compared with states without DUR programs.…”

“…56 However, drug expenditures per recipient and total drug expenditures were 4.9% and 6.5% lower, respectively, in states with DUR programs compared with states without DUR programs. The authors also report no significant spillover effects on nonpharmaceutical expenditures.…”