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Volumn 23, Issue 8, 2017, Pages 893-901

The effect of formulary restrictions on patient and payer outcomes: A systematic literature review

Author keywords

[No Author keywords available]

Indexed keywords

CLINICAL OUTCOME; COCHRANE LIBRARY; COST CONTROL; DRUG CONTROL; DRUG COST; DRUG INFORMATION; DRUG UTILIZATION; ECONOMIC EVALUATION; EMBASE; FORMULARY RESTRICTION; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HUMAN; MEDICATION COMPLIANCE; MEDLINE; OUTCOME ASSESSMENT; PATIENT SATISFACTION; PATIENT-REPORTED OUTCOME; PHARMACOECONOMICS; PHARMACY; RESOURCE MANAGEMENT; REVIEW; SYSTEMATIC REVIEW; CALIFORNIA; COST BENEFIT ANALYSIS; ECONOMICS; PATIENT ATTITUDE; PROCEDURES; REIMBURSEMENT; TREATMENT OUTCOME;

EID: 85025630214     PISSN: 23760540     EISSN: 23761032     Source Type: Journal    
DOI: 10.18553/jmcp.2017.23.8.893     Document Type: Review
Times cited : (56)

References (82)
  • 1
    • 85016203030 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services. National health expenditures 2015 highlights. Available at: https://www. cms. gov/Research-Statistics-Dataand-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights. pdf. Accessed June 28, 2017
    • National health expenditures 2015 highlights
  • 15
    • 34347381507 scopus 로고    scopus 로고
    • Goldman DP, Joyce GF, Zheng Y. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. JAMA. 2007;298(1):61-69
    • JAMA
    • Goldman, D.P.1    Joyce, G.F.2    Zheng, Y.3
  • 18
    • 79952610512 scopus 로고    scopus 로고
    • Motheral BR. Pharmaceutical step-therapy interventions: a critical review of the literature. J Manag Care Pharm. 2011;17(2):143-55. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2011. 17. 2. 143
    • J Manag Care Pharm
    • Motheral, B.R.1
  • 25
    • 84875829031 scopus 로고    scopus 로고
    • Labiner DM, Drake KW. Formularies, costs, and quality of care: formulary restrictions are not the answer, especially for epilepsy. Neurol Clin Pract. 2013;3(1):71-74
    • Neurol Clin Pract
    • Labiner, D.M.1    Drake, K.W.2
  • 26
    • 84903143339 scopus 로고    scopus 로고
    • Happe LE, Clark D, Holliday E, Young T. A systematic literature review assessing the directional impact of managed care formulary restrictions on medication adherence, clinical outcomes, economic outcomes, and health care resource utilization. J Manag Care Spec Pharm. 2014;20(7):677-84. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2014. 20. 7. 677
    • J Manag Care Spec Pharm
    • Happe, L.E.1    Clark, D.2    Holliday, E.3    Young, T.4
  • 29
    • 78651443240 scopus 로고    scopus 로고
    • Cochrane Effective Practice and Organisation of Care. EPOC resources for review authors. 2017. Available at: epoc. cochrane. org/epoc-resourcesreview-authors. Accessed June 28, 2017
    • EPOC resources for review authors
  • 30
    • 84872154596 scopus 로고    scopus 로고
    • Critical Appraisal Skills Programme (CASP). 10 questions to help you make sense of qualitative research. Qualitative Research Checklist 31. 05. 13. Available at: http://media. wix. com/ugd/dded87_29c5b002d99342f788c6ac6 70e49f274. pdf. Accessed June 14, 2017
    • 10 questions to help you make sense of qualitative research
  • 31
    • 85030185199 scopus 로고    scopus 로고
    • Accurso AJ. The effect of a payer-mandated decrease in buprenorphine dose on relapse rates of patients with opioid dependence, a natural experiment. Presented at: SGIM 38th Annual Meeting; April 22-25, 2015; Toronto, ON, Canada. Available at: https://higherlogicdownload. s3. amazonaws. com/SGIM/d307f134-78da-4fb8-beae-def2a3c048e5/UploadedImages/AM15%20 docs/Oral%20Presentations/Abstract%20Session%20I4. pdf. Accessed June 14, 2017
    • Presented at: SGIM 38th Annual Meeting
    • Accurso, A.J.1
  • 32
    • 85006648333 scopus 로고    scopus 로고
    • Blomquist J. Generic first strategy in PPI class drives lowest net cost. J Manag Care Pharm. 2010;16(7):533 [Abstract]. Available at: http://www. jmcp. org/doi/pdf/10. 18553/jmcp. 2010. 16. issue-7
    • J Manag Care Pharm
    • Blomquist, J.1
  • 33
    • 84878968748 scopus 로고    scopus 로고
    • Bergeson JG, Worley K, Louder A, Ward M, Graham J. Retrospective database analysis of the impact of prior authorization for type 2 diabetes medications on health care costs in a Medicare advantage prescription drug plan population. J Manag Care Pharm. 2013;19(5):374-84. Available at: http://www. jmcp. org/doi/10. 18553/jmcp. 2013. 19. 5. 374
    • J Manag Care Pharm
    • Bergeson, J.G.1    Worley, K.2    Louder, A.3    Ward, M.4    Graham, J.5
  • 36
    • 84907292890 scopus 로고    scopus 로고
    • Ben-Joseph R, Chen CC, De AP, Wade RL, Shah D. Consequences of patient access restrictions to branded oxycodone hydrochloride extendedrelease tablets on healthcare utilization and costs in U. S. health plans. J Med Econ. 2014;17(10):708-18
    • J Med Econ
    • Ben-Joseph, R.1    Chen, C.C.2    De, A.P.3    Wade, R.L.4    Shah, D.5
  • 40
    • 85030185218 scopus 로고    scopus 로고
    • Devine JW, Trice S, Allerman AA, Bacon TA. The effect of a prior authorization program for proton-pump inhibitors on medication persistence among the elderly. Value Health. 2009;12(3):A60 [Abstract PGI12]. Available at: http://www. valueinhealthjournal. com/article/S1098-3015(10)73359-3/abstract. Accessed June 14, 2017
    • Value Health
    • Devine, J.W.1    Trice, S.2    Allerman, A.A.3    Bacon, T.A.4
  • 41
    • 85006648333 scopus 로고    scopus 로고
    • Cotter ND. Promoting the ADA's diabetes type 2 treatment guidelines through pharmacy step-therapy programs. J Manag Care Pharm. 2011;17(7):568 [Abstract]. Available at: http://www. jmcp. org/doi/pdf/10. 18553/jmcp. 2011. 17. issue-7
    • J Manag Care Pharm
    • Cotter, N.D.1
  • 43
    • 85030185196 scopus 로고    scopus 로고
    • Erdman DR, LeBlanc L, Christiansen B, Gregory RS. Aromatase inhibitors utilization management opportunities: assessment of patient diagnoses, cost savings, and controlling off-label use. J Manag Care Pharm. 2010;16(2):142 [Abstract]. Available at: http://www. jmcp. org/doi/pdf/10. 18553/jmcp. 2010. 16. issue-2
    • J Manag Care Pharm
    • Erdman, D.R.1    LeBlanc, L.2    Christiansen, B.3    Gregory, R.S.4
  • 44
    • 33746454327 scopus 로고    scopus 로고
    • Dunn JD, Cannon E, Mitchell MP, Curtiss FR. Utilization and drug cost outcomes of a step-therapy edit for generic antidepressants in an HMO in an integrated health system. J Manag Care Pharm. 2006;12(4):294-302. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2006. 12. 4. 294
    • J Manag Care Pharm
    • Dunn, J.D.1    Cannon, E.2    Mitchell, M.P.3    Curtiss, F.R.4
  • 50
    • 85030185453 scopus 로고    scopus 로고
    • Hatoum HT, Lin S-J, Balu S. Impact of 5-hydroxytryptamine-3 receptor antagonist step therapy on severe chemotherapy-induced nausea and vomiting events in patients with lymphoma. Blood. 2011;118(21):3137 [Abstract 3137]. Available at: http://www. bloodjournal. org/content/118/21/3137?ssochecked= true. Accessed June 14, 2017
    • Blood
    • Hatoum, H.T.1    Lin, S.-J.2    Balu, S.3
  • 51
    • 84901240626 scopus 로고    scopus 로고
    • Keast SL, Thompson D, Farmer K, Smith M, Nesser N, Harrison D. Impact of a prior authorization policy for montelukast on clinical outcomes for asthma and allergic rhinitis among children and adolescents in a state Medicaid program. J Manag Care Spec Pharm. 2014;20(6):612-21. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2014. 20. 6. 612
    • J Manag Care Spec Pharm
    • Keast, S.L.1    Thompson, D.2    Farmer, K.3    Smith, M.4    Nesser, N.5    Harrison, D.6
  • 53
    • 84990922964 scopus 로고    scopus 로고
    • Johnston SS, Udall M, Alvir J, et al. Association between pregabalin access restrictions and pain-related health care utilization and expenditures in Medicare supplemental health plans. J Manag Care Pharm. 2012;18(7):542 [Abstract]. Available at: http://www. jmcp. org/doi/pdf/10. 18553/jmcp. 2012. 18. issue-7
    • J Manag Care Pharm
    • Johnston, S.S.1    Udall, M.2    Alvir, J.3
  • 54
    • 79953058061 scopus 로고    scopus 로고
    • Lu CY, Adams AS, Ross-Degnan D, et al. Association between prior authorization for medications and health service use by Medicaid patients with bipolar disorder. Psychiatr Serv. 2011;62(2):186-93
    • Psychiatr Serv
    • Lu, C.Y.1    Adams, A.S.2    Ross-Degnan, D.3
  • 55
    • 79952510681 scopus 로고    scopus 로고
    • Lu CY, Law MR, Soumerai SB, et al. Impact of prior authorization on the use and costs of lipid-lowering medications among Michigan and Indiana dual enrollees in Medicaid and Medicare: results of a longitudinal, population-based study. Clin Ther. 2011;33(1):135-44
    • Clin Ther
    • Lu, C.Y.1    Law, M.R.2    Soumerai, S.B.3
  • 56
    • 85018181119 scopus 로고    scopus 로고
    • LaPensee K, Carson R, Werner P, et al. Effect of equivalent and nonequivalent substitution of prescribed drugs for depression and anxiety disorders on patients' treatment adherence and perception. Value Health. 2010;13(3):A118 [Abstract PMH75]. Available at: http://www. valueinhealthjournal. com/article/S1098-3015(10)72570-5/abstract. Accessed June 14, 2017
    • Value Health
    • LaPensee, K.1    Carson, R.2    Werner, P.3
  • 59
    • 77952497558 scopus 로고    scopus 로고
    • Law MR, Lu CY, Soumerai SB, et al. Impact of two Medicaid priorauthorization policies on antihypertensive use and costs among Michigan and Indiana residents dually enrolled in Medicaid and Medicare: results of a longitudinal, population-based study. Clin Ther. 2010;32(4):729-41
    • Clin Ther
    • Law, M.R.1    Lu, C.Y.2    Soumerai, S.B.3
  • 60
    • 84979455810 scopus 로고    scopus 로고
    • Shen X, Stuart B, Powers C, Tom S, Magder L, Perfetto EM. How do formulary restrictions affect medication use and costs for low-income subsidy recipients in Medicare part d plans? Value Health. 2016;19(3):A261 [Abstract PHP17]. Available at: http://www. valueinhealthjournal. com/article/S1098-3015(16)00863-9/abstract. Accessed June 14, 2017
    • Value Health
    • Shen, X.1    Stuart, B.2    Powers, C.3    Tom, S.4    Magder, L.5    Perfetto, E.M.6
  • 63
  • 65
    • 33947617760 scopus 로고    scopus 로고
    • Nau DP, Chi C, Mallya U, Kirking DM. Member satisfaction related to self-reported cost share and difficulty in obtaining prescription drugs in a university pharmacy benefit plan. J Manag Care Pharm. 2007;13(2):135-41. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2007. 13. 2. 135
    • J Manag Care Pharm
    • Nau, D.P.1    Chi, C.2    Mallya, U.3    Kirking, D.M.4
  • 67
    • 85030185109 scopus 로고    scopus 로고
    • Seabury S, Lakdawalla DN, Walter D, et al. Medicaid formulary restrictions and expenditures for patients with major depressive disorder. Value Health. 2014;17(3):A222 [Abstract PMH78]. Available at: http://www. valueinhealthjournal. com/article/S1098-3015(14)01348-5/abstract. Accessed June 14, 2017
    • Value Health
    • Seabury, S.1    Lakdawalla, D.N.2    Walter, D.3
  • 69
    • 77953303956 scopus 로고    scopus 로고
    • Simeone JC, Marcoux RM, Quilliam BJ. Cost and utilization of behavioral health medications associated with rescission of an exemption for prior authorization for severe and persistent mental illness in the Vermont Medicaid program. J Manag Care Pharm. 2010;16(5):317-28. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2010. 16. 5. 317
    • J Manag Care Pharm
    • Simeone, J.C.1    Marcoux, R.M.2    Quilliam, B.J.3
  • 72
    • 84946414829 scopus 로고    scopus 로고
    • Suehs BT, Sikirica V, Mudumby P, Dufour R, Patel NC. Impact of a step therapy for guanfacine extended-release on medication utilization and health care expenditures among individuals receiving treatment for ADHD. J Manag Care Spec Pharm. 2015;21(9):793-802, 802a-i. Available at: http://www. jmcp. org/doi/10. 18553/jmcp. 2015. 21. 9. 793
    • J Manag Care Spec Pharm
    • Suehs, B.T.1    Sikirica, V.2    Mudumby, P.3    Dufour, R.4    Patel, N.C.5
  • 76
    • 77951045951 scopus 로고    scopus 로고
    • West JC, Wilk JE, Rae DS, et al. First-year Medicare part D prescription drug benefits: medication access and continuity among dual eligible psychiatric patients. J Clin Psychiatry. 2010;71(4):400-10
    • J Clin Psychiatry
    • West, J.C.1    Wilk, J.E.2    Rae, D.S.3
  • 77
    • 34248328405 scopus 로고    scopus 로고
    • Yokoyama K, Yang W, Preblick R, Frech-Tamas F. Effects of a step-therapy program for angiotensin receptor blockers on antihypertensive medication utilization patterns and cost of drug therapy. J Manag Care Pharm. 2007;13(3):235-44. Available at: http://www. jmcp. org/doi/abs/10. 18553/jmcp. 2007. 13. 3. 235
    • J Manag Care Pharm
    • Yokoyama, K.1    Yang, W.2    Preblick, R.3    Frech-Tamas, F.4
  • 79
    • 77951572313 scopus 로고    scopus 로고
    • Walthour A, Seymour L, Tackett R, Perri M. Assessment of changes in utilization of health-care services after implementation of a prior authorization policy for atypical antipsychotic agents. Ann Pharmacother. 2010;44(5):809-18
    • Ann Pharmacother
    • Walthour, A.1    Seymour, L.2    Tackett, R.3    Perri, M.4
  • 81
    • 85030185328 scopus 로고    scopus 로고
    • Zhang Z, Jannsen X, Rogers N, Shetty S, Etemad L. Impact of generic step therapy of divalproex ER, levetiracetam, lamotrigine, and topiramate on health care utilization in epilepsy patients. J Manag Care Pharm. 2012;18(2):183 [Abstract]. Available at: http://www. jmcp. org/doi/pdf/10. 18553/jmcp. 2012. 18. issue-2
    • J Manag Care Pharm
    • Zhang, Z.1    Jannsen, X.2    Rogers, N.3    Shetty, S.4    Etemad, L.5
  • 82
    • 85030185480 scopus 로고    scopus 로고
    • Whiteley J, Landsman-Blumberg PB, Cao Z, Alvir J, Harnett J. Effects of a desvenlafaxine prior authorization on health care resource utilization and costs in commercially insured patients. J Manag Care Pharm. 2011;17(7):557 [Abstract]. Available at: http://www. jmcp. org/doi/pdf/10. 18553/jmcp. 2011. 17. issue-7
    • J Manag Care Pharm
    • Whiteley, J.1    Landsman-Blumberg, P.B.2    Cao, Z.3    Alvir, J.4    Harnett, J.5


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.