Closing Drug Formularies Not Easy, Overnight Job

By Muirhead, Greg | Drug Topics, February 5, 1996 | Go to article overview

Closing Drug Formularies Not Easy, Overnight Job


Muirhead, Greg, Drug Topics


Closing a formulary isn't easy. But that's the task more and more managed care organizations have taken on as drug manufacturers demand more proof that their drug discounts to MCOs result in increased market share for their products.

Bob Matsick, an associate at consulting firm Coopers & Lybrand's integrated health-care services division, based in San Francisco, tried to shed some light on the movement to close formularies. He has been working with drug manufacturers to help MCOs more effectively enforce their closed or otherwise restricted formularies.

Many people are confused as to what it really means to have a closed formulary, he pointed out. "People tend to think of formularies as 'open' and 'closed,' or 'restricted' and 'unrestricted,' and that's not the way to look at it. The way to look at it is across a spectrum."

A formulary becomes increasingly closed as an MCO defines its preferred list of drugs and then goes about the process of enforcing it through a variety of financial incentives and sanctions directed at pharmacists, physicians, and patients, he explained.

On the pharmacy side, an MCO's ability to either approve or deny a drug claim on-line, at the point of dispensing, is the simplest (if harshest) approach to formulary enforcement, he noted. But physicians and patients, who prefer the freedom to choose from a wide range of drug choices, need to be motivated to make a closed formulary effective.

Drug manufacturers are gradually getting more involved in formulary compliance with the help of their sales forces, Matsick said. …

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