The arrival of economic evidence in managed care formulary decisions: the unsolicited request process.
Managed care plans have traditionally resisted using economic evidence explicitly in drug formulary decisions, even as they used ever more aggressive and sophisticated processes for managing care. In recent years, this has changed as health plans have begun to adopt evidence-based and value-based formulary submission guidelines. The guidelines have the potential to serve as a national unifying template for pharmacy and therapeutics committees to consider clinical and economic information in a systematic and rigorous fashion. However, many questions remain about their use and about the nature of communications (called "unsolicited requests") from plans to drug companies for information. This article describes the unsolicited request process and its potential impact on the use of economic evidence in formulary decisions.
Neumann
Peter J
PJ
Department of Policy and Decision Sciences, Harvard School of Public Health, Boston, Massachusetts 02115, USA. pneumann@hsph.harcard.edu
D003362:Cost-Benefit Analysis; D004345:Drug Industry / Q000191:economics*; D004346:Drug Information Services; D017850:Economics, Pharmaceutical; D005569:Formularies as Topic; D008329:Managed Care Programs / Q000191:economics*; D011050:Policy Making; D014481:United States; D014486:United States Food and Drug Administration