The arrival of economic evidence in managed care formulary decisions: The unsolicited request process

Medical Care

Volumn 43, Issue 7 SUPPL., 2005, Pages

  Neumann, Peter J ^a  

^a HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

Cost effectiveness analysis; Drug formularies

Indexed keywords

COST BENEFIT ANALYSIS; DRUG INDUSTRY; DRUG INFORMATION; ECONOMICS; FOOD AND DRUG ADMINISTRATION; HEALTH INSURANCE; MANAGEMENT; PHARMACOECONOMICS; PUBLICATION; REVIEW; UNITED STATES;

COST-BENEFIT ANALYSIS; DRUG INDUSTRY; DRUG INFORMATION SERVICES; ECONOMICS, PHARMACEUTICAL; FORMULARIES; MANAGED CARE PROGRAMS; POLICY MAKING; UNITED STATES; UNITED STATES FOOD AND DRUG ADMINISTRATION;

EID: 22944458493     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (27)

1. Neumann PJ, Zivin KD, Ramakrishnan V, et al. Economic messages in prescription drug advertisements in leading medical journals. Med Care. 2002;40:840-845.
2. Stewart KA, Neumann PJ. FDA actions against misleading or unsubstantiated economic and quality-of-life claims: an analysis of warning letters and notices of violation. Value in Health. 2002;5:389-396.
3. Neumann PJ. Evidence-based and value-based formulary guidelines. Health Aff (Millwood). 2004;23:124-134.
4. US Food and Drug Administration. Federal Food, Drug and Cosmetic Act and Code of Federal Regulations for Prescription Drug Advertising and Labeling. Available at: http://www.fda.gov/cder/ddmac/SELECTED_PROVISIONS_2ND.HTM. Accessed May 2, 2004.
5. Burke LB. US Regulation of Pharmaceutical Outcomes Research: Presented at the ISPOR 5th Annual Meeting, Crystal City, VA, 24 May 2000. Value in Health. 2001;4:5-7.
6. Neumann PJ, Claxton K, Weinstein MC. The PDA's regulation of health economic information. Health Aff (Millwood). 2000c;19:129-137.
7. Dillon MJ. Drug Formulary Management. In: Navarro RP, ed. Managed Care Pharmacy Practice. Gaithersburg, MD: Aspen Publication; 1999:145-166.
8. Gold M. The changing US health care system. Milbank Q. 1999;77:3-32.
9. Mathematica Policy Research. The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit. Report for the Henry J. Kaiser Family Foundation, January 2000.
10. Luce BR, Lyles AC, Rentz AM. The view from managed care pharmacy. Health Aff (Millwood). 1996;4:168-176.
11. Sloan FA, Whetten-Goldstein K, Wilson A. Hospital pharmacy decisions, cost-containment, and the use of cost-effectiveness analysis. Soc Sci Med. 1997;45:525-533.
12. Titlow K, Randel L, Clancy CM, et al. Drug coverage decisions: the role of dollars and values. Health Aff (Millwood). 2000;19:240-247.
13. Singer SJ, Bergthold LA. Prospects for improved decision making about medical necessity. Health Aff (Millwood). 2001;1:200-206.
14. Jacobson PD, Kanna ML. Cost-effectiveness analysis in the courts: recent trends and future prospects. Journal of Health Policy, Politics, and Law. 2001;26:291-326.
15. Sacramento HealthCare Decisions. Cost-effectiveness as a Criterion for Medical and Coverage Decisions: Understanding and Responding to Community Perspectives. Rancho Cordova, CA; October 2001.
16. Kowalczyk L. Drug costs still ensnare health plans. Boston Globe. August 29, 2002:A1.
17. Regence Washington Health Pharmacy Service. Guidelines for Submission of Clinical and Economic Data Supporting Formulary Considerations, version 1.2. Seattle: Regence Washington Health, University of Washington; September 1997.
18. Sullivan SD, Lyles A, Luce B, et al. AMCP guidance for submission of clinical and economic evaluation data to support formulary listing in US health plans and pharmacy benefits management organizations. Journal of Managed Care Pharmacy. 2001;7:272-282.
19. AMCP Format for Formulary Submissions, version 2.0. Alexandra, VA: Academy of Managed Care Pharmacy (October 2002). Available at: http://www.fmcpnet.org/data/resource/formatv20.pdf. Accessed February 14, 2005.
20. Otrompke J. A new format for making more cost-effective drug coverage decisions takes off. Business and Health. January 31, 2002.
21. Kaiser Commission on Medicaid and the Uninsured. Oregon's Medicaid PDL: Will an Evidence-Based Formulary With Voluntary Compliance Set a Precedent for Medicaid? Henry J. Kaiser Family Foundation, January 2004.
22. Stergachis A. Format for formulary submissions: challenges, opportunities, and expectations for industry. Presentation at the AMCP Educational Conference; Dallas, TX; October 21, 2002.
23. Jstreetdata Fast Alert Study. Attitudes Towards Adoption of the AMCP Formulary Guidelines. Washington, DC: Jstreetdata; November 2, 2001.
24. Robinson AM. AMCP's Format for Formulary Submissions: an evolving standard. Results of two recent surveys. Presentation at the 15th Annual Meeting of the Academy of Managed Care Pharmacy; Minneapolis, MN; April 9-12, 2003.
25. Mitchell AS. Antipodean assessment: activities, actions, and achievements. International Journal of Technology Assessment in Health Care. 2002;18:203-212.
26. Neumann PJ. Paying the piper for pharmacoeconomic studies. Medical Decision Making. 1998;18(suppl):S23-26.
27. Neumann PJ. Why don't Americans use cost-effectiveness analysis? Am J Managed Care. 2004;10:308-312.