Utilization and Drug Cost Outcomes of a Step-Therapy Edit for Generic Antidepressants in an HMO in an Integrated Health System

Dunn, Jeffrey D.; Cannon, H. Eric; Mitchell, Matthew P.; Curtiss, Frederic R.

doi:10.18553/jmcp.2006.12.4.294

Cited by 29 publications

(24 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[18][19][20] Throught he examinationo fo ne aspect of thehumanistic-service outcomes, thepresent studyexpands ourunderstanding of PA programs.S pecifically, we examined some of thef actors associated with theu ptakeo fap olicy designed to allowp harmacists to applyf or PA on behalf of theirp atientsa nd thep erceptions of communityp harmacists associated with this policy.…”

Section: Discussionmentioning

confidence: 84%

“…15 Since1999,whenlicensedpharmacists in Saskatchewanwere allowed to initiate EDSr equests,r esearchh as notb een conducted on howthe policy affectscommunity pharmacy practice. As noted in previous studiesonPAorstep-therapyprograms, [17][18][19][20] oftenthe drug costsand savingsare evaluated whilethe perspective of thep roviders (e.g., pharmacists) aren ot addressed. This paperr eports on thee xperiences ando pinionso fc ommunity pharmacy managers,o rt heir delegates,a nd theirp harmacies with regard to Saskatchewan Health's EDSp rogram andi ts effect on communityp harmacy.…”

Section: Saskatchewanmentioning

confidence: 99%

See 1 more Smart Citation

Perceptions of Saskatchewan Community Pharmacists Regarding a Prior-Authorization Program

Perepelkin

Dobson²

2007

JMCP

View full text Add to dashboard Cite

Background:In1999,SaskatchewanHealth authorized pharmacists to initiate exception drug status (EdS)requests,also knownasprior authorization (Pa).Before 1999,onlythose licensedtoprescribe medications were authorizedtoinitiate EdSrequests. apharmacistwho submitsan EdSrequest must obtain apatientdiagnosis fromthe physicianoragent of thephysician; adiagnosis presented by thepatientisinsufficient. oBjEctIvE: to obtain pharmacists'opinionsabout thebenefitsofthe Pa programofthe SaskatchewandrugPlanand to identify factorsassociated with pharmacist-initiatedEdS requests.MEtHodS:acensus survey of community pharmacy managerswas conducted viaaself-administered postalquestionnaireinthe province of Saskatchewan, canada,inthe fall of 2004.the survey questionnairewas addressedtopharmacy managers, some of whom mayhavedelegated the response to astaff pharmacist. Pharmacy managersortheirdelegates were askedtorespond on behalf of allpharmacists in their pharmacies.rESuLtS:aresponse rate of 82.6%was achieved(275/333). amajority of respondentsagreedthatthe province's Pa program(EdS) benefited patients (87.3%)and theSaskatchewandrugPlan(82.5%),whereas only 33.4%ofrespondentsagreedthatthe EdSprogram benefited pharmacists.Pharmacists'ability to obtain therequisite information(87.6%) and to contactthe prescribingphysician(87.3%),aswellaspatient-centered concerns such as thepatient'sability to payfor theprescription (85.1%), were themostimportant factors. thetime required by thepharmacisttoinitiate therequest wasnot important relativetoother factors. community pharmacies reported receiptofanaverage of 36.4 prescriptionsfor restricted andnonformularydrugs per week,ofwhich 22 were submittedfor Pa coverage,1 7bythe pharmacy and5bythe pharmacy at therequest of thephysician.concLuSIonS:the resultsofthisstudy indicate that community pharmacists in Saskatchewanacknowledge that theEdS process is beneficial for their patients.However,pharmacists areburdenedbyanadministrative process in whichnecessary information, particularlythe patientdiagnosis, is notreadilyavailable. What is alreadyknown aboutthissubjectWhat this studyadds M edicareinCanadaisaf ederal programthathas evolved over nearly40years to provideCanadiansaccesstomedicallyn ecessary physician andh ospitals ervices, includingdrugs administered in hospitals. However, each provincial and territorialg overnmenti ndependently developeda nd continuest o developp rogramst op rovide drug coveragef or some or allo fi ts residentsinthe communityorinnonhospital facilities.The federal government hasalsodeveloped andcontinuestodevelop drug programsf or select groups,including veterans andF irst Nations and Inuitpeoples.However,morethanhalfofall prescriptionsare paid throughprivate insuranceordirectly by individualsorpatients. 1,2 In 2005,Canadahad 7,778community pharmacies comprising chaina nd banner pharmacies (58.6%), independent pharmacies (21.4%), andpharmaciesinfood andmass merchandisers (20.0%). 3 In 2005 in Saskatchewan, public fundspaidfor 48%ofthe $554 perc apitas pent on prescriptio...

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Saskatchewanmentioning

confidence: 99%

Perceptions of Saskatchewan Community Pharmacists Regarding a Prior-Authorization Program

Perepelkin

Dobson²

2007

JMCP

View full text Add to dashboard Cite

show abstract

“…[8][9][10] ■■ Results Fourteen evaluations of ST programs have been published to date. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Seven of the studies were conducted in commercial populations (Table 1), while 7 assessed Medicaid ST programs (Table 2). An analysis by Panzer et al (2005) was an economic model of an antidepressant ST program for patients with anxiety, 15 and Cox et al (2004) surveyed members with an ST edit/ reject to assess their responses to the edit.…”

Section: ■■ Methodsmentioning

confidence: 99%

Pharmaceutical Step-Therapy Interventions: A Critical Review of the Literature

Motheral¹

2011

JMCP

View full text Add to dashboard Cite

• Nearly 60% of commercial payers reported having 1 or more step-therapy (ST) programs in 2010, making it one of the most popular pharmacy benefit management tools. However, adoption of ST is quickly outpacing understanding of its clinical, humanistic, and economic outcomes.• Previous reviews of drug cost management tools have reported drug cost savings from ST, highlighted higher discontinuation rates, and identified gaps in the literature related to inclusion of quality of care metrics. Prior critical reviews have focused primarily on the lack of inclusion of a broad range of relevant outcomes rather than on study quality, particularly internal validity. What is already known about this subjectPharmaceuticalStep-Therapy Interventions: A Critical Review of the Literature Brenda R. Motheral, RPh, MBA, PhD ABSTRACT BACKGROUND: Adoption of step therapy (ST) is quickly outpacing the market's understanding of its clinical, humanistic, and economic outcomes. The broad scope of previous reviews of drug management programs has prohibited an in-depth discussion of the ST literature specifically.

show abstract

“…These programs include the nonsteroidal anti-inflammatory drugs (NSAIDs) including cyclooxygenase-2 (COX-2) inhibitors, proton pump inhibitors (PPIs), and selective serotonin reuptake inhibitors (SSRIs). 4,5 The reported savings ranged from zero to $0.36 PMPM with SSRIs to $0.48 with PPIs. The lack of SSRI savings in one study and the substantial savings in another may be the result, in part, of the sole availability of fluoxetine as a generic drug in the first analysis and the subsequent availability of 3 generic SSRIs at the time of the more recent study.…”

Section: Commentary Nn Assessing Step-therapy Programs: a Step In Thementioning

confidence: 99%

Assessing Step-Therapy Programs: A Step in the Right Direction

Gleason¹

2007

JMCP

View full text Add to dashboard Cite

Utilization and Drug Cost Outcomes of a Step-Therapy Edit for Generic Antidepressants in an HMO in an Integrated Health System

Cited by 29 publications

References 40 publications

Perceptions of Saskatchewan Community Pharmacists Regarding a Prior-Authorization Program

Perceptions of Saskatchewan Community Pharmacists Regarding a Prior-Authorization Program

Pharmaceutical Step-Therapy Interventions: A Critical Review of the Literature

Assessing Step-Therapy Programs: A Step in the Right Direction

Contact Info

Product

Resources

About