Application of pharmacoeconomics to formulary decision making in managed care organizations.
OBJECTIVE
To discuss the apparent value of incorporating pharmacoeconomic studies into pharmacy and therapeutic committee decision making; current internal and external barriers to the use of pharmacoeconomic studies; and possible solutions to the problems.


METHODS
Literature review.


RESULTS
The formulary system assists healthcare providers in the evaluation, appraisal, and selection of drugs. Unfortunately, managed care organizations usually evaluate drugs exclusively on clinical efficacy, safety, and daily acquisition cost without considering overall cost effectiveness. Factors that have been impeding the use of pharmacoeconomic data include departmental budgetary constraints, tardy publications, limited reliability of available studies, and a lack of knowledge required to evaluate such studies.


CONCLUSIONS
To remain competitive, managed care organizations need to incorporate pharmacoeconomic consideration into their formulary decision-making process. Performing an institutionwide economic evaluation; conducting pharmacoeconomic studies earlier, perhaps along with clinical trials; using decision analysis; developing standardized guidelines; and increasing education can help overcome current barriers.
Suh
Dong-Churl
DC
College of Pharmacy, Rutgers-The State University of New Jersey, Piscataway 08854, USA. dsuh@rci.rutgers.edu
Okpara
Ijeoma R N
IR
Agnese
Wendy B
WB
Toscani
Michael
M
D002017:Budgets; D003659:Decision Making, Organizational; D017850:Economics, Pharmaceutical; D005569:Formularies as Topic; D017408:Guidelines as Topic; D007318:Inservice Training; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D010606:Pharmacy and Therapeutics Committee; D014481:United States