The Nebraska Medicaid Drug Utilization Review Program

There are reports in the literature which address the effects of DUR on morbidity and cost containment in a non-acute setting. Most of the information, however, is under acute care circumstances. Some of the studies performed under these situations have shown added benefits in terms of patient care. This article attempts to document similar changes in morbidity and cost containment in a relatively ambulatory Medicaid population. It must be remembered that the Medicaid population in Nebraska is composed of some patients who are institutionalized in a variety of settings. In 1989, the Medicaid population had an average age close to 65. Forty-three percent of these patients resided in a nursing home and may have either received hospitalization as a result of a Drug Therapy Problem or incurred added expenses while maintaining residency in a long-term care environment. The cost savings noted here do not reflect other factors such as the effects of age, race, gender, residential status, diet, smoking, exercise, disease prior to Medicaid enrollment, etc. This estimate does not take into account the effects of increased ingredient or administrative costs. Any increases in claims amount over time would tend to boost cost savings while increases in administrative expenses would tend to blunt this effect. If an adjustment was made for age, gender and other factors, cost-savings could be affected. Additionally, the DUR program does not include any drug effects which could be attributable to changes in other prescribed medications secondary to the original inquiry.(ABSTRACT TRUNCATED AT 250 WORDS)