Medicaid Drug Utilization Review: A Critical Appraisal

Arkansas Pharmacists Association and Health Information Designs , Inc. DUR Base—Arkansas Pre/Post Intervention Analysis , Little Rock, AR, 29 January 1991.

Avorn, J. , and S.B. Soumerai. "Improving Drug-Therapy Decisions through Educational Outreach." The New England Journal of Medicine 308 (16 June 1983): 1457-63

. Beck, R.G. "The Effects of Copayment on the Poor." Journal of Human Resources (Winter 1974): 129-42

. Comptroller General of the United States. Programs to Control Prescription Drug Costs under Medicaid and Medicare Could be Strengthened (HRD-81-36). Washington, DC: General Accounting Office, 30 December 1980 .

Demsetz, H. "Information and Efficiency: Another Viewpoint." Journal of Law and Economics 12 (April 1969): 1-22

. Eisenberg, J.M. Doctors' Decisions and the Cost of Medical Care Ann Arbor, MI: Health Administration Press, 1986.

Eisenberg, J.M. , and S.V. Williams. "Cost-Containment and Changing Physicians' Practice Behavior." Journal of the American Medical Association 246 (November 1981): 2195-2201

. Ermann, D. "Hospital Utilization Review: Past Experience, Future Directions." Journal of Health Politics, Policy and Law 13, no. 4 (1988): 683-96.

Ernst and Young. Cost-Effectiveness of the Medi-Cal Therapeutic Drug Utilization Review Program for the State of California Sacramento, CA: Office of the Auditor General, 1991.

Ginsburg, P.B. , and L.M. Manheim. "Insurance, Copayment and Health Services Utilization: A Critical Review." Journal of Economics and Business 25 (1973): 142-53

. Grabowski, H. "Medicaid Patients' Access to New Drugs." Health Affairs 7 (Winter 1988): 102-114

. Groves, R.E. "Therapeutic Drug-Use Review for the Florida Medicaid Program." American Journal of Hospital Pharmacy 42 (February 1985): 316-19

. Health Information Designs, Inc. A Study of the Impact of Inappropriate Ambulatory Drug Therapy on Hospitalization, United States (Mimeo Washington, DC: Health Care Financing Administration, May 1978.

———. DUR Base—Michigan Hospitalization Risk Analysis Report Lansing, MI, 26 November 1991.

Holahan, J. , and B. Stuart. Controlling Medicaid Utilization Patterns Washington, DC: The Urban Institute, 1977.

Huntsinger, L. "Drug Use Review of Oregon." Pharmacy Times (May 1990): 39-41

. Jaskow, P.L. "Alternative Regulatory Mechanisms for Controlling Hospital Costs." In A New Approach to the Economics of Health Care. Edited by M. Olsen. Washington, DC: American Enterprise Institute, 1991, pp. 219-57.

Kusserow, R.P., Inspector General. Medicare Drug Utilization Review Washington, DC: Office of the Inspector General, April 1989.

Larizzo, R.J. , and J.M. Eisenberg. "Prescription Drugs, Practicing Physicians, and the Elderly." Health Affairs 9 (Fall 1990): 20-35

. Lipowski, E.E. , and T.M. Collins. "Wisconsin Medicaid DUR Project." The Wisconsin Pharmacist 57 (February 1988): 20, 37, and 30

. Masson, A. , and R.L. Steiner. Generic Substitution and Prescription Drug Prices: Economic Effects of State Drug Product Substitution Laws Report (M371), Bureau of Economics, Federal Trade Commission. Washington, DC, 1985.

Melmon, K.L. "Preventable Drug Reactions: Causes and Cures." The New England Journal of Medicine 284 (June 1971 ): 1361-68

. Moore, W.J. , and R.J. Newman. "Drug Formulary Restrictions as a Cost-Containment Policy in Medicaid Programs." Journal of Law and Economics (April 1994 ): 71-97

. National Pharmaceutical Council. Pharmaceutical Benefits under State Medical Assistance Programs Washington, DC: NPC, 1991.

———. Pharmaceutical Benefits under State Medical Assistance Programs Washington, DC: NPC, 1992, p. 112.

Nebraska Pharmacists Association and Department of Social Services, State of Nebraska. 1991 Annual Report: Nebraska Medicaid Drug Utilization Review Program, Lincoln, NE, 1992.

Nebraska Pharmacists Association and Health Information Designs, Inc. DUR Base—Nebraska Hospital Risk Analysis Report , Lincoln, NE, 30 January 1993 .

Nelson, A.A. , C.E. Reeder , and W.M. Dickson. "The Effect of Medicaid Drug Copayment Program on the Utilization and Cost of Prescription Services." Medical Care 22 (August 1984): 724-35

. Nycamp, D. "Impact of Drug-Regimen Review on the Georgia Medicaid Program." The Consultant Pharmacist 5, no. 4(April 1990): 235-38

. Peters, J. "Oregon Medicaid Drug Use Review." Oregon Pharmacist 36 (1988): 36

. Pollard, M.R. , and J.M. Coster. "Savings for Medicaid Drug Spending." Health Affairs 10 (Summer 1991 ): 196-206

. Ray, W.A. , M.R. Griffin , W. Schaffner , D.K. Baugh , and L.J. Melton III. "Psychotropic Drug Use and the Risk of Hip Fracture." The New England Journal of Medicine 316 (12 February 1987): 363-69

. Ray, W.A. , W. Schaffner , and C.F. Federspiel . "Persistence and Improvement in Antibiotic Prescribing in Office Practice." Journal of the American Medical Association 253 (22 March 1985 ): 1774-76

. Ray, W.A. , M.R. Griffin , and R.I. Shorr. "Adverse Drug Reactions and the Elderly." Health Affairs 9 (Fall 1990): 114-22

. Schaffner, W. , W.A. Ray , C.F. Federspiel , and W.O. Miller. "Improving Antibiotic Prescribing in Office Practice.: Journal of the American Medical Association 2509 (7 October 1983): 1728-32

. Schwartz, W.B. , and D.N. Mandelson. "Hospital Cost Containment in the 1980s: Hard Lessons Learned and Prospects for the 1990s." The New England Journal of Medicine 324 (11 April 1991): 1037-42

. Shapiro, S. , D.S. Slone , G.P. Lewis , and H. Jick. "Fatal Drug Reactions among Medical Inpatients." Journal of the American Medical Association 216 (19 April 1971): 467-72.

Soumerai, S.B. , and J. Avorn. "Efficiency and Cost Containment in Hospital Pharmacotherapy: State of the Art and Future Directions." Milbank Memorial Fund Quarterly: Health and Society 62, no. 3(1984): 447-74

. Soumerai, S.B. , and J. Avorn. "Economic and Policy Analysis of University-Based Drug Detailing." Medical Care 24 (April 1986): 313-31

. Soumerai, S.B. , T.J. McLaughlin , and J. Avorn. "Improving Drug Prescribing in Primary Care: A Critical Analysis of the Experimental Literature." The Milbank Quarterly 67, no. 2 ( 1989): 268-317

. Soumerai, S.B. , and D. Ross-Degnan. "Experience of State Drug Benefit Programs." Health Affairs 9 (Fall 1990): 36-54

. Soumerai, S.B. , T.S. McLaughlin , and J. Avorn. "Withdrawing Payment for Nonscientific Drug Therapy." Journal of the American Medical Association 263 (9 February 1990): 831-39

. SRI International. The Medi-Cal Therapeutic Drug Utilization Review Project, Quarterly Report and Final Analysis Report, Menlo Park, CA, July 1991

. Wickizer, T.M. "Effect of Utilization Review on Hospital Use and Expenditures : A Review of the Literature and an Update on Recent Findings." Medical Care Review 47, No. 3 (Fall 1990): 327-63

. Zuckerman, S. "Medicaid Hospital Spending: Effects of Reimbursement and Utilization Control Policies." Health Care Financing Review 9 (Winter 1987): 65-77.