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State Design and Use of Prior Authorization Processes
Comparative effectiveness | Preferred Drug List
This brief summarizes six state’s experiences in implementing and operating prior authorization (PA) processes that support a preferred drug list (PDL). The PA process can be divided into three major components: Submission, Review, and Appeal. This brief examines state policy choices and experience in each of these areas. It also examines...
David Bergman
Neva Kaye, Managing Director, Health System Performance
March 2006
State Efforts to Manage the Behavioral Health Pharmaceutical Benefit
Comparative effectiveness | Medicaid | Preferred Drug List
This brief discusses the hurdles states face in better managing behavioral health pharmaceuticals. In recent years, increases in cost and shifts in utilization are making psychotropic medicines one of the largest cost centers for Medicaid pharmacy programs.
David Bergman
Neva Kaye, Managing Director, Health System Performance
March 2006
State Experience in Creating Effective P&T Committees
Comparative effectiveness | Preferred Drug List | State roles
This brief summarizes state experience in creating and managing Pharmaceutical and Therapeutics (P&T) committees. The brief points out that states face critical issues in designing and implementing their efforts that range from the make-up of their P&T committees, to the way in which prior approval requests are submitted.
David Bergman
Neva Kaye, Managing Director, Health System Performance
March 2006
Understanding Key Features of the Drug Effectiveness Review Project (DERP) and Lessons for State Policy Makers
Comparative effectiveness | Preferred Drug List | System performance
This brief summarizes the key features of the Drug Effectiveness Review Project (DERP). The DERP is a collaborative partnership between states and other government and non-profit entities that conducts systematic evidence-based reviews of pharmaceuticals. It is the largest effort to apply current best practices and evidence-based analysis to...
Jack Hoadley, Jeffrey Crowley
March 2006