New Findings in Medicare and Medicaid Described from University of Maryland (Impact of Formulary Restrictions on Medication Use and Costs)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Current study results on Medicare and Medicaid have been published. According to news reporting originating in Baltimore, Maryland, by VerticalNews journalists, research stated, "To evaluate the effects of formulary restrictions on utilization and costs of oral hypoglycemic agents (OHAs), statins, and renin-angiotensin system (RAS) antagonists among low-income subsidy (LIS) recipients in Medicare Part D plans. We analyzed a 5% sample of 2012 Medicare data from the Chronic Conditions Data Warehouse together with a customized dataset capturing beneficiaries' histories of plan assignment."

The news reporters obtained a quote from the research from the University of Maryland, "We constructed 3 nonexclusive study cohorts comprising of users of OHAs, statins, and RAS antagonists. Eligible study subjects were LIS recipients randomized to benchmark plans. Formulary restrictions of interest were noncoverage, prior authorization, and step therapy. Study outcomes included generic dispensing rate (GDR), mean cost per prescription fill, and medication adherence based on proportion of days covered (PDC). Random intercept regression models were performed to estimate the effects of formulary restrictions on the study outcomes by drug class. After covariate adjustment, beneficiaries who were subject to formulary restrictions on brand name pioglitazone and single-source brand name dipeptidyl peptidase-4 inhibitors (saxagliptin, sitagliptin, and sitagliptin-metformin) had a GDR 3 percentage points higher and a cost per prescription fill $10.8 less, but similar PDC compared with those who faced no restrictions. Restricting access to brand name atorvastatin and single-source brand name statins (rosuvastatin and ezetimibe-simvastatin) was associated with a GDR 14.9 percentage points higher and a cost per prescription fill $29.6 less, but with no impact on PDC. Restricting use of single-source brand name RAS antagonists (olmesartan, valsartan, and valsartan-hydrochlorothiazide) was associated with a GDR 15.0 percentage points higher, a cost per prescription fill $27.2 less, and a PDC 1.3 percentage points lower."

According to the news reporters, the research concluded: "Placing formulary restrictions on brand name drugs shifts utilization toward generic drugs, lowers the overall cost per prescription fill, and has minimal impact on overall adherence for OHAs, statins, and RAS antagonists among LIS recipients."

For more information on this research see: Impact of Formulary Restrictions on Medication Use and Costs. American Journal of Managed Care, 2017;23(8):E265-E274. American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

Our news correspondents report that additional information may be obtained by contacting X. Shen, University of Maryland, Dept. of Pharmaceut Hlth Serv Res, Baltimore, MD 21201, United States. Additional authors for this research include B.C. Stuart, C.A. Powers, S.E. Tom, L.S. Magder and E.M. Perfetto.

Keywords for this news article include: Baltimore, Maryland, United States, North and Central America, Medicare and Medicaid, Health Policy, Medicare, University of Maryland.

Our reports deliver fact-based news of research and discoveries from around the world. Copyright 2017, NewsRx LLC