Comparative effectiveness research in practice: the Drug Effectiveness Review Project experience.
OBJECTIVE
Assess the effect of the Drug Effectiveness Review Project's comparative effectiveness research findings on prescribing behavior independently and in conjunction with a Medicaid preferred drug list.


METHODS
We queried prescription drug claims and enrollment information from the 2001-2008 Medicaid Analytic eXtract and Medicaid Statistical Information System for 17 states using a Wilcoxon signed rank test design to evaluate the effects of the Drug Effectiveness Review Project's report release and preferred drug list implementation on ACE inhibitor prescribing behavior at a state level. The primary outcome of interest was the percentage of ACE inhibitor prescriptions that are defined as 'differentiated' based on the content of the Drug Effectiveness Research Program report.


RESULTS
The use of differentiated ACE inhibitors increased significantly in states that participated in the Drug Effectiveness Research Program and subsequently implemented a preferred drug list (p < 0.05, one-tailed). However, there was no significant change in utilization in nonparticipating states or in states that participated but did not subsequently implement a preferred drug list.


CONCLUSIONS
Although the publication of comparative effectiveness research findings may not directly influence practice, a preferred drug list can align utilization with clinical evidence. The states that participate in the Drug Effectiveness Review Project and use preferred drug lists have greater utilization of higher quality drugs, making the combination an effective strategy to translate comparative effectiveness research into practice.
Centers for Medicare & Medicaid Services, US Department of Health & Human Services, Baltimore, MD, USA.
Jordan M
JM
VanLare
Hui-Hsing
HH
Wong
Jonathan
J
Gibbs
Rolf
R
Timp
Stephanie
S
Whang
Chris
C
Worrall
Jeffrey
J
Kelman
Patrick H
PH
Conway
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000600:supply & distribution*; D057186:Comparative Effectiveness Research; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D006801:Humans; D008484:Medicaid; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000600:supply & distribution*; D014481:United States
D000806:Angiotensin-Converting Enzyme Inhibitors; D055553:Prescription Drugs