{"title":"A Prescription for Drug Formulary Evaluation: An Application of Price Indexes.","authors":"Jacob Glazer, Haiden A Huskamp, Thomas G McGuire","doi":"10.1515/1558-9544.1296","DOIUrl":null,"url":null,"abstract":"<p><p>Existing economic approaches to the design and evaluation of health insurance do not readily apply to coverage decisions in the multi-tiered drug formularies characterizing drug coverage in private health insurance and Medicare. This paper proposes a method for evaluating a change in the value of a formulary to covered members based on the economic theory of price indexes. A formulary is cast as a set of demand-side prices, and our measure approximates the compensation (positive or negative) that would need to be paid to consumers to accept the new set of prices. The measure also incorporates any effect of the formulary change on plan drug acquisition costs and \"offset effects\" on non-drug services covered by the plan. Data needed to calculate formulary value are known or can be forecast by a health plan. We illustrate the method with data from a move from a two- to a three-tier formulary.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"15 2","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2012-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3556729/pdf/nihms426801.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Forum for Health Economics and Policy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1515/1558-9544.1296","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Economics, Econometrics and Finance","Score":null,"Total":0}
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Abstract
Existing economic approaches to the design and evaluation of health insurance do not readily apply to coverage decisions in the multi-tiered drug formularies characterizing drug coverage in private health insurance and Medicare. This paper proposes a method for evaluating a change in the value of a formulary to covered members based on the economic theory of price indexes. A formulary is cast as a set of demand-side prices, and our measure approximates the compensation (positive or negative) that would need to be paid to consumers to accept the new set of prices. The measure also incorporates any effect of the formulary change on plan drug acquisition costs and "offset effects" on non-drug services covered by the plan. Data needed to calculate formulary value are known or can be forecast by a health plan. We illustrate the method with data from a move from a two- to a three-tier formulary.
期刊介绍：
Forum for Health Economics & Policy (FHEP) showcases articles in key substantive areas that lie at the intersection of health economics and health policy. The journal uses an innovative structure of forums to promote discourse on the most pressing and timely subjects in health economics and health policy, such as biomedical research and the economy, and aging and medical care costs. Forums are chosen by the Editorial Board to reflect topics where additional research is needed by economists and where the field is advancing rapidly. The journal is edited by Katherine Baicker, David Cutler and Alan Garber of Harvard University, Jay Bhattacharya of Stanford University, Dana Goldman of the University of Southern California and RAND Corporation, Neeraj Sood of the University of Southern California, Anup Malani and Tomas Philipson of University of Chicago, Pinar Karaca Mandic of the University of Minnesota, and John Romley of the University of Southern California. FHEP is sponsored by the Schaeffer Center for Health Policy and Economics at the University of Southern California. A subscription to the journal also includes the proceedings from the National Bureau of Economic Research''s annual Frontiers in Health Policy Research Conference. Topics: Economics, Political economics, Biomedical research and the economy, Aging and medical care costs, Nursing, Cancer studies, Medical treatment, Others related.
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