Do open formularies increase access to clinically useful drugs?

Area of Science:

• Health Policy
• Pharmacoeconomics
• Public Health

Background:

• State Medicaid programs previously used restrictive formularies, limiting access to prescription drugs.
• These formularies were criticized for potentially denying essential medications to vulnerable populations.
• Legislation in 1990 disallowed restrictive formularies in Medicaid programs nationwide.

Purpose of the Study:

• To evaluate the impact of eliminating restrictive Medicaid formularies on access to top-selling prescription drugs.
• To assess the therapeutic benefit of the prescription drugs affected by this policy change.

Main Methods:

• Analysis of the 200 top-selling prescription drugs in the United States.
• Comparison of drug access before and after the 1990 Omnibus Budget Reconciliation Act.

Main Results:

• Improved access was observed for a subset of the top-selling drugs after restrictive formularies were disallowed.
• The majority of these widely-sold drugs provided questionable or no significant additional therapeutic benefit.

Conclusions:

• The removal of Medicaid restrictive formularies enhanced patient access to certain high-selling medications.
• The policy change did not substantially improve the availability of drugs with significant therapeutic advancements.