Impact of a transition to more restrictive drug formulary on therapy discontinuation and medication adherence

Journal of Clinical Pharmacy and Therapeutics
E ShirneshanWilliam H Shrank

Abstract

There is conclusive evidence demonstrating that formulary restrictions are associated with reduced utilization and pharmacy spending of the restricted drugs. However, prior efforts to implement restrictive formularies have been associated with inconsistent rates of therapy discontinuation and mixed impacts on adherence to therapy. Also, the impact of transferring patients from an already restrictive formulary to a more aggressive model has not been previously examined. This study evaluated the impact of implementation of a more restrictive formulary on therapy disruption, adherence rates, pharmacy costs and generic utilization among patients with common chronic conditions. In 2014, CVS Health implemented Value Formulary (VF), a restrictive benefit design with the aim of reducing spending while preserving access to and adherence to essential therapy, was used. A retrospective cohort study was conducted to assess changes in therapy disruption rates, pharmacy costs and generic dispensing rate (GDR) (for continuers) and medication adherence (for initiators) following the implementation of VF. The study group was selected from members of three existing employer clients transitioned from standard formulary (SF) to VF on January 2014....Continue Reading

References

May 16, 2006·Social Science & Medicine·Kathryn E FlynnDavid Vanness
Dec 4, 2008·JAMA : the Journal of the American Medical Association·Aaron S KesselheimWilliam H Shrank
Mar 12, 2009·Health Affairs·William H ShrankNiteesh K Choudhry
Apr 3, 2009·Psychiatric Services : a Journal of the American Psychiatric Association·Yuting ZhangStephen B Soumerai
Jan 6, 2011·The Annals of Pharmacotherapy·William H ShrankNiteesh K Choudhry
Mar 26, 2011·The American Journal of Medicine·William H ShrankNiteesh K Choudhry
Sep 16, 2014·Annals of Internal Medicine·Joshua J GagneWilliam H Shrank

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Citations

May 14, 2019·Postgraduate Medicine·Richard DolinarElaine Nguyen

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