Review of the Drug Utilization Review Program of United States 47 States and Suggestion of Policy
Title
Review of the Drug Utilization Review Program of United States 47 States and Suggestion of Policy
Author(s)
전하림
; 박주희
; 김동숙
; 최병철
Keyword
DUR
; 메디케이드 DUR 연간 보고서
; Drug Utilization Review
; Medicaid DUR Annual Report
Publication Year
2014-09-30
Publisher
Korea Institute for Health and Social Affairs
Citation
Health and Social Welfare Review Vol.34 No.3, pp.192-221
Abstract
Inappropriate drug use induces the increase of unnecessary medical expenditure caused by adverse drug events. Drug Utilization Review(DUR), which is one way for preventing inappropriate prescribing, screening prescription claims to identify drug related problems, and finally it should be improved patient safety and reduced the evitable medical costs. In the United States, Omnibus Budget Reconciliation Act of 1990 (OBRA’90) requires to be reported on each state’s prescribing patterns, cost savings to Center for Medicare and Medicaid Services (CMS) via Medicaid Drug Utilization Review Annual Report Survey. A Korea’s DUR program was implemented in partial area in April, 2008. Afterward, the necessity for expanding to the nationwide area has been required, but there have insufficient data to be referred for assessment, criteria and plan. The purpose of this study was to review DUR annual Report for FFY 2010 of United States, and to suggest a development plan suitable for use with domestic situation. We reviewed that Medicaid DUR annual report of 47 states and summarized POS vendor, the types of criteria, etc, and described retrospective DUR case of some states. Based on the review of DUR annual report in the USA, we suggest that the expansion of the scope and criteria of Korea’s DUR. Moreover, the integrated management for appropriate medication use and retrospective DUR should be conducted.