Issues in the Design and Implementation of Drug Formularies and Therapeutic Classes
Submitted to: Steve SheingoldOffice of the Assistant Secretary for Planning and Evaluation (ASPE)U.S. Department of Health and Human Services
This report is available on the Internet at:http://aspe.hhs.gov/health/reports/05/DrugFormularies/index.htm
- Introduction (in PDF format)
- Classification Systems and Formularies (in PDF format)
- Role, Structure, and Content of Classification Systems
- The P&T Committee Process
- Policy Implications: Classification Systems, Formularies, and P&T committees
- The USP Classification System (in PDF format)
- Background: How does the USP Classification System Work?
- Policy Implications: The USP System
- The CMS Rules for Formularies (in PDF format)
- Background: How do the CMS Formulary Rules Work?
- Coverage of Commonly Used Drugs Under CMS Rules
- Policy Implications: Adequacy of Coverage Under the CMS Rules
- Would "Real World" formularies meet CMS Rules?
- Policy Implications: Will "Real World" Formularies Pass the CMS Tests?
- Formulary Analysis Model (in PDF format)
- The Methodology: The Formulary Simulation Model
- Prototype Formularies in the Model
- Policy Implications: Analyzing Prototype Formularies
- "Real World" Formularies in the Modes
- Policy Implications: Potential for Risk Selection
- Potential for Refining the Model
- Conclusions and Possible future Research (in PDF format)
- Classification Systems and Formularies
- Appendix A: Tables describing classification systems and formularies
- Appendix B: Crosswalks showing drugs as classified by different systems
- Appendix C: Information from plan interviews
- USP Classification System and CMS Rules
- Appendix D: MCBS utilization by USP class and category
- Appendix E: Commonly used drugs
- Appendix F: Do real world formularies meet CMS tests?
- Formulary Analysis Model
- Appendix G: Additional information on elasticity
- Appendix H: Elasticity panel members
- Appendix I: Additional information on model
- Formulary Simulation Model
"execsum_40.pdf" (pdf, 57.17Kb)