The Effect of Incentive-Based Formularies on Prescription-Drug Utilization and Spending

The New England Journal of Medicine--December 2003
Vol. 43, No. 23
December 2003
Huskamp H, Deverka P, Epstein A, Epstein R, and McGuigan, K., and R. Frank
pp. 2224-32

BACKGROUND:  Many employers and health plans have adopted incentive-based formularies in an attempt to control prescription-drug costs.

CONCLUSION: Different changes in formulary administration may have dramatically different effects on utilization and spending and may in some instances lead enrollees to discontinue therapy. The associated changes in copayments can substantially alter out-of-pocket spending by enrollees, the continuation of the use of medications, and possibly the quality of care.


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