Literature Review Examines Value of Managed Care Pharmacy Tools

An Academy of Managed Care Pharmacy (AMCP)-sponsored review of the published scientific literature concludes there is strong evidence to demonstrate the effectiveness of managed care pharmacy tools in achieving intended outcomes, such as increased utilization of preferred drugs, formulary compliance and decreased prescription drug spending. The study also concludes that additional research is required to provide a comprehensive understanding of the value of managed care pharmacy tools (see also Managed Care).

The Academy contracted with Abt Associates in 2009 to examine peer-reviewed research on several managed care pharmacy tools and activities, such as tiered drug formularies, prior authorizations and drug utilization reviews. AMCP released the findings as a July/August Supplement to the Journal of Managed Care Pharmacy (JMCP). The literature demonstrates that managed care pharmacy continues to make health care more affordable for patients and payers, according to the study, Effect of 6 Managed Care Pharmacy Tools: A Review of the Literature. The document by Abt Associates also indicates that while there is a significant body of literature on several managed care pharmacy interventions, there are other interventions that require additional research to provide decision makers with a more comprehensive understanding of the value of managed care pharmacy tools. This is especially true in the examination of clinical and humanistic outcomes.

In a letter to readers of the supplement, AMCP Executive Director Judith Cahill and AMCP President Brian Sweet, Chief Pharmacy Officer at WellPoint, Inc., identify two limitations that should be noted in interpreting the conclusions in this report.

First, the literature search was restricted to research conducted within managed care organizations. Therefore it represents only a portion of the available literature. Second, the published literature does not represent the full array of research in the area of managed care pharmacy. Managed care organizations analyze internal data on a regular basis to make determinations about the success or appropriateness of continued use of managed care tools. However, this valuable internal research is not often made public and, therefore, is not included in this literature review.

"We encourage managed care organizations both to publish studies based on analyses on existing internal data and to conduct new research in managed care pharmacy interventions that is focused on patient outcomes. This information is valuable to both health care practitioners in managed care settings and to policy makers," Cahill and Sweet conclude their letter. Effect of 6 Managed Care Pharmacy Tools: A Review of the Literature can be found on the AMCP website at www.amcp.org/data/jmcp/JulSuppA.pdf. A complete annotated bibliography and literature summary tables were also developed and are available online at: www.amcp.org/bibliography.pdf and www.amcp.org/summarytables.pdf, respectively. About AMCP The Academy of Managed Care Pharmacy (AMCP) is a national professional association of pharmacists and other health care practitioners who serve society by the application of sound medication management principles and strategies to improve health care for all. The Academy's nearly 6,000 members develop and provide a diversified range of clinical, educational and business management services and strategies on behalf of the more than 200 million Americans covered by a managed care pharmacy benefit. More news and information about AMCP can be obtained on its website, at www.amcp.org. The Academy is observing its 20th anniversary in 2009.