Preferred drug lists: potential impact on healthcare economics.
OBJECTIVE
To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare.


METHODS
We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included "drug lists," "prior authorization," "prior approval," and "Medicaid." We added terms such as "influence use of other healthcare services," "quality of care," and "overall economic impact." We mainly used primary sources.


RESULTS
Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c) the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact.


CONCLUSIONS
The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care.
Pharmaceutical Research Institute at Albany College of Pharmacy, Albany, New York 12208, USA.
Kimberly
K
Ovsag
Sabrina
S
Hydery
Shaker A
SA
Mousa
D017046:Cost Savings; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D004363:Drug Utilization / Q000191:economics*; D005569:Formularies as Topic; D017048:Health Care Costs; D006282:Health Personnel; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006298:Health Services Administration / Q000191:economics; D006302:Health Services Research; D006801:Humans; D008484:Medicaid / Q000191:economics* / Q000458:organization & administration; D010349:Patient Compliance; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000458:organization & administration; D011787:Quality of Health Care / Q000191:economics* / Q000458:organization & administration; D013997:Time Factors; D014481:United States