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Monitoring Trends after Adoption of New York’s Drug Formulary
Vennela Thumula, Te-Chun Liu
March 30, 2023 Related Topics: Drug Formularies, Physician Dispensing, Prescription Drugs and Opioids
This report is a part of a series of studies that examine the impact of drug formularies in five states (Arkansas, California, Indiana, Kentucky, and New York) that implemented formularies in 2018 and 2019. As of January 1, 2023, 17 states have adopted drug formularies, with several other states considering implementation. Findings from this study should therefore be of interest to stakeholders in New York as well as those in other states considering the implementation of drug formularies in their jurisdictions.
In this study, we examine the impact of the partial implementation of the New York workers’ compensation formulary on prescription drug utilization and costs, using detailed transaction data for all prescriptions filled between January 1, 2016, and March 31, 2021, by workers within 12 months of injury.
The New York formulary went into effect for new prescriptions on December 5, 2019. The formulary regulated prescribing to be based on medications that are effective and appropriate for the treatment of work-related injuries, consistent with the New York State Workers’ Compensation Board Medical Treatment Guidelines.
Monitoring Trends after Adoption of New York’s Drug Formulary. Vennela Thumula and Te-Chun Liu. March 2023. WC-23-25.
Copyright: WCRI
pdf, 399KB
Research Questions:
- Did the formulary reduce overall prescription utilization?
- What was the impact on drugs with different status under the New York workers’ compensation formulary—formulary drugs, formulary drugs with limits, and non-formulary drugs?
- What was the impact on various drug groups—opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), dermatological agents, musculoskeletal therapy agents, anticonvulsants, compounds, and others?
- How did generic utilization change after the drug formulary?
- Did the formulary reduce prescription payments per claim?
