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Principles for evidence-based drug formulary policy
Gregory E Simon1, Bruce M Psaty, Jennifer Berg Hrachovec
1Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. simon.g@ghc.org
Journal of General Internal Medicine
|September 30, 2005
Summary
This study outlines five principles for using research evidence in drug formulary decisions to manage rising prescription drug costs. It emphasizes prioritizing experimental data, clinical outcomes, and comprehensive comparisons for effective cost-effectiveness analysis.
Area of Science:
- Health Economics
- Pharmacoeconomics
- Evidence-Based Medicine
Background:
- Rising prescription drug expenditures necessitate cost-containment strategies by insurers and health systems.
- Formulary policies aim to restrict expensive medications, but require careful evaluation of complex claims.
Purpose of the Study:
- To present five key principles for applying research evidence to drug formulary decision-making.
- To guide insurers and health systems in evaluating treatment claims for efficacy, safety, and cost-effectiveness.
Main Methods:
- The study describes and illustrates five principles for evidence application in formulary decisions.
- Principles focus on prioritizing experimental data, clinical outcomes, and comprehensive treatment comparisons.
Main Results:
- Experimental data and morbidity/mortality outcomes should be prioritized over models and surrogate outcomes.
- Comparisons should include all alternatives, not just industry-selected ones.
- Predictable variations in treatment effects support or oppose restrictions on new or ongoing therapies.
Conclusions:
- Adherence to these principles can improve the rigor of formulary decision-making.
- Economic incentives may influence research priorities, particularly in pharmacogenomics and drug repurposing.