Report Summarizes Managed Care Study Findings from Diagnostica Stago (The Effect of Formulary Restrictions on Patient and Payer Outcomes: A…

Report Summarizes Managed Care Study Findings from Diagnostica Stago (The Effect of Formulary Restrictions on Patient and Payer Outcomes: A Systematic Literature Review)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Data detailed on Managed Care have been presented. According to news originating from East Hanover, New Jersey, by VerticalNews correspondents, research stated, "Formulary restrictions are implemented to reduce pharmacy costs and ensure appropriate use of pharmaceutical products. As adoption of formulary restrictions increases with rising pharmacy costs, there is a need to better understand the potential effect of formulary restrictions on patient and payer outcomes."

Our news journalists obtained a quote from the research from Diagnostica Stago, "To conduct a systematic literature review that assesses the effect of formulary restrictions on the following outcomes: medication adherence, clinical outcomes, treatment satisfaction, drug utilization, health care resource utilization, and economic outcomes. Studies published in 2005 or later were identified from the MEDLINE, Embase, and Cochrane databases and the National Health Service Economic Evaluation Database, using 2 sets of search terms. A total of 17 formulary restriction terms (e.g., step therapy [ST] and prior authorization [PA]) and 55 outcome terms were included, resulting in 935 unique search term combinations. Two reviewers independently conducted analyses of the titles, abstracts, and full-text articles. The search was limited to English-language articles that evaluated the effect of ST and/or PA placed by U.S. third-party payers on the following outcomes: patient outcomes (medication adherence, clinical outcomes, and treatment satisfaction) and payer outcomes (drug utilization, health care resource utilization, and economic outcomes). Of 2,321 reviewed articles, 59 articles met the study inclusion criteria. The included studies assessed the effect of ST (n=18), PA (n=35), or both (n=6) on medication adherence (n=14), clinical outcomes (n=12), treatment satisfaction (n=2), drug utilization (n=39), health care resource utilization (n=18), and economic outcomes (n=42). The 59 articles measured 164 outcomes across the patient, health care resource utilization, and economic outcome categories of interest. Of the total number of outcomes, 50.6% (n=83) were negative in direction or were unfavorable, whereas 40.2% (n=66) were positive in direction or were favorable, when the perspectives of patients and payers were considered. Of the total number of drug utilization outcomes reported (n=46), the majority showed lower drug utilization (>90%). However, in some of the articles, pharmacy cost savings resulting from lower drug utilization appeared to be offset by increased medical costs."

According to the news editors, the research concluded: "Formulary coverage decisions may have unintended consequences on patient and payer outcomes despite lower drug utilization and pharmacy cost savings; therefore, careful evaluation of restrictions before policy implementation and continued reevaluation after implementation is warranted."

For more information on this research see: The Effect of Formulary Restrictions on Patient and Payer Outcomes: A Systematic Literature Review. Journal of Managed Care & Specialty Pharmacy, 2017;23(8):893-901. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news correspondents report that additional information may be obtained from Y. Park, Novartis Pharmaceut, East Hanover, NJ, United States. Additional authors for this research include S. Raza, A. George, R. Agrawal and J. Ko.

Keywords for this news article include: East Hanover, New Jersey, United States, North and Central America, Managed Care, Article Review, Diagnostica Stago.

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