WCRI FlashReport: Texas-Like Formulary for Louisiana State Employees

By Vennela Thumula, Te-Chun Liu

February 16, 2018 Related Topics: Drug Formularies

This FlashReport focuses on how a Texas-like closed formulary might affect the prevalence and costs of drugs prescribed to Louisiana state employees. It does not study the impact of a drug formulary on patient outcomes and overall medical costs or estimate the potential cost savings for all workers’ compensation claims in the state. It provides a broad range of estimates that depend on different assumptions regarding provider behavior in adopting a Texas-like formulary.

The Texas formulary includes all drugs approved by the Food and Drug Administration (FDA) except drugs with “N” drug status in the current edition of the Official Disability Guidelines (ODG), compound drugs that contain “N” drugs, and investigational or experimental drugs. If a drug is included in the formulary, physicians may prescribe it without obtaining preauthorization. If the drug is excluded from the formulary, physicians may only prescribe it if they obtain preauthorization from the payor.

Detailed prescription transaction data for all Louisiana state employee claims managed by the Office of Risk Management (ORM) were collected for this study. The data used in this analysis include approximately 45,000 prescriptions filled between January 1, 2016, and June 30, 2017, by Louisiana state employees who received at least one prescription paid under the state workers’ compensation program. 

WCRI FlashReport: Texas-Like Formulary for Louisiana State Employees. Vennela Thumula and Te-Chun Liu. February 2018. FR-18-01.

 

Copyright: WCRI

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Research Questions:

  • How frequently are non-formulary drugs that require preauthorization under the Texas closed formulary prescribed to Louisiana state employees? And what are the frequently prescribed non-formulary drugs?
  • What proportion of the prescription costs are for non-formulary drugs?
  • If a Texas-like closed formulary is implemented, what are the potential prescription cost savings?

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