Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
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Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices f Medicare Formulary Restrictions On Evidence-Based Prescribing PracticesAishwarya VijayFollow this and additional works at: https://elischolar.library.yale.edu/ymtdlRecommended CitationVijay. Aishwarya, ‘Influence Of Medicare Formulary Restrictions On Evidence-Based Prescribing Practices' (2019). Y Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices ale Medicine Thesis Digital Library. 3961.https://elischolar.library.yale.edu/ymtdl/3961This Open Access Thesis is brought to you for free and open acLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
cess by the School of Medicine at EliScholar - A Digital Platform for Scholarly Publishing at Yale. It has been accepted for inclusion in Yale MedicinYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices ase contact elischoiar@yaie edu.Influence of Medicare Formulary Restrictions on Evidence-BasedPrescribing PracticesA Thesis Submitted to the Yale University School of Medicine in Partial Fulfillment of the Requirements for the Degree of Doctor of MedicineByAishwarya Vijay20201AbstractControlling the Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices cost of prescription drugs is integral to improving health outcomes, and patient access and adherence to treatment. While prescription drugs can ofteLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
n provide essential therapeutic benefit, previous studies have suggested that inappropriate prescription drug use is a principal cause of adverse drugYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices omponent of healthcare delivery in the United Stales, Ihcre arc multiple ways appropriate prescription drug use is promoted. Black-box warnings and drug labeling controlled by the FDA as well as guidelines released by the CDC. such as the 2013 guidelines released during the opioid epidemic, aim to p Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices romote appropriate prescription at a population level. At a patient-level, drug formularies have multiple strategies in place to promote safe and costLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
-effective prescribing of individual medications.The Center for Medicare & Medicaid Services (CMS) makes use of prescription drug formularies that areYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices y limits, prior authorization, and step therapy, in order to promote safe, evidence-based and cost-effective prescribing. These strategies are in place to impact drug prescription rates as well as to incentivize use of biological or therapeutically interchangeable generics over brand-name drugs. Thu Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices s far. the implementation of utilization management strategies for commonly prescribed drugs has not been thoroughly studied.This study presents threeLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
main analyses conducted and published in the peer reviewed literature during my time in medical school. The first characterized the change in opioid Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices delines encouraging prescription on non-opioid analgesic alternatives. We found that overall rates of pain medication prescribing were high and that opioid pain medication prescription increased in the outpatient setting only, whereas non-opioid pain medication prescribing increased in both the outp Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices atient and ED settings, an area that has not been previously reported or well-investigated.The second study characterized how Medicare formulary restrLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
ictions were applied to opioid “potentiators", which are commonly used in conjunction with opioids and increase patients’ risk of adverse events. We fYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices notic. and gabapentinoid coverage with small increases in use of quantity limits, and that more than a quarter of formularies provided unrestrictive coverage of these potentially unsafe opioid potentiators in 2017.The third and tinal study herein presents a more global analysis of whether Medicare u Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices sed formulary restrictions to promote prescription of therapeutically interchangeable generics over the top 100-grossing brand-name drugs in light ofLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
the 2020 CMS plans for an indicationbased formulary design. We showed that a substantial portion of CMS formularies provided similarly restrictive covYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices sing opportunities to incentivize prescribing of less costly generics.Overall, the results of this comprehensive study on safe and cost-effective drug prescription showed that while current formulary design includes opportunities to reduce costly and potentially unsafe prescribing, the impact of the Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices se tools is sub-optimal. These results highlight the need for both physician and patient education on the utility of the formulary3restriction strategLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
ies. On a larger scale, it suggests that these strategies alone may not be sufficient to reduce over-prescription of potentially unsafe drugs like opiYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices proposed an indication-based formulary design starting in 2020. allowing Medicare Advantage and Part D prescription drug plans to cover drugs only for select indications, which could increase formulary negotiating power and secure more competitive pricing. This might be the change needed in order to Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices ensure continued patient access to affordable and safe prescription drugs.AcknowledgementsThis thesis is the product of 3.5 years of research conductLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
ed as a medical student at Yale. When I first started at Yale Medical School. I had just finished a global health project in Malaysia working with marYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices etermining health outcomes, sometimes far more than the actual clinical encounter. I wanted to conduct research that effected change at a larger, more structural level, research that would affect patients across different ages, gender, ethnicity and ideology. This body of work addresses issues in pr Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices escribing practices at a nationwide, policy level in order to promote cost-effective, evidence-based access to drugs for all patients. 1 hope it willLuận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
have a part in changing the way we prescribe medicine as a medical community. I also aim to use it to inform my own clinical practice during and afterYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence Of Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices ical school. 1 am grateful for your time, advice and thoughts over these past four years. I would also like to thank Dr. Sankei Dhruva. who has acted not only a research mentor and collaborator but also as an invaluable source of career and life advice. 1 am eternally grateful for the generous fundi Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices ng the Yale School of Medicine has provided through the years to enable me to devote my time to this work. Finally. I would like to thank my parents,Luận văn thạc sĩ influence of medicare formulary restrictions on evidence based prescribing practices
my sister. Varsha, and my fiancé. Steen, for their constant support of my pursuits.Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence OfYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43466Influence OfGọi ngay
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