Drug product selection in Illinois: the first year's experience

Area of Science:

• Health Economics
• Pharmacy Practice
• Public Health Policy

Background:

• The Illinois Drug Product Selection (DPS) law allows pharmacists to substitute generic drugs for prescribed brands.
• Evaluating the economic and practical impacts of such laws is crucial for healthcare policy.
• Understanding prescriber-pharmacist communication and formulary impacts is essential.

Purpose of the Study:

• To evaluate the effectiveness and impact of Illinois' Drug Product Selection (DPS) law.
• To assess consumer savings and identify barriers to DPS implementation.
• To analyze the influence of pharmacy type and location on DPS and prescription pricing.

Main Methods:

• Audit of prescription data to determine the frequency and outcomes of DPS.
• Analysis of prescription formats for clarity and communication effectiveness.
• Comparison of prescription prices across different pharmacy types and locations.

Main Results:

• Consumers saved an average of $1.47 per prescription when DPS occurred.
• The mandated prescription format hindered clear communication between prescribers and pharmacists.
• DPS occurred in 12.6% of audited prescriptions, limited by a positive formulary approach.
• DPS was more frequent in urban pharmacies, where savings were higher but "dispensed as written" prices were also elevated.
• Prescription prices varied by pharmacy type but not by urban or rural location.

Conclusions:

• While Illinois' DPS law offers consumer savings, its implementation faces challenges due to prescription format and formulary restrictions.
• Targeted interventions in urban community pharmacies may enhance DPS, but pricing disparities need consideration.
• Further policy refinement is needed to optimize DPS benefits while ensuring clear communication and equitable pricing.