title: The effect of a closed formulary on prescription drug use and costs.
abstract: This study examines the effect of a closed formulary on pharmaceutical use and spending. We compared an employer plan that implemented a closed formulary in July 1997 to a control group with an open formulary, for the nine months preceding and following implementation of the formulary. When controlling for age, gender, and chronic disease score, the closed formulary was associated with significantly lower increases in utilization and expenditures, a higher prior authorization rate, and a reduced rate of continuation with chronic medications in the nine months following its implementation. These findings have implications for the design of prescription drug benefits.
authors.affiliation: Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson 85719, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Motheral
authors.forename: R
authors.initials: R
authors.lastname: Henderson
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002908:Chronic Disease / Q000188:drug therapy; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000191:economics* / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D005569:Formularies as Topic; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012737:Sex Factors; D016019:Survival Analysis; D014481:United States