Prescribing Rules Cut Use of Pfizer, Merck Painkillers in Study
By Michelle Fay Cortez
Nov. 17 (Bloomberg) -- State insurance programs for the poor
cut costs by requiring prior approval for prescriptions of pain
drugs made by companies such as Pfizer Inc., according to a study
in the Nov. 18 New England Journal of Medicine.
Prescription-drug costs consume more than 10 percent of
health-care spending in the U.S. One reason for rising costs is
the introduction of expensive new drugs, such as the Pfizer
painkillers Celebrex and Bextra and Merck & Co.'s now-recalled
Vioxx. The medications don't work better than cheaper drugs,
though they are less likely to cause ulcers.
After the drugs were approved in the late 1990s, some
programs required doctors to get approval before prescribing them
to low-income Medicaid beneficiaries. The new rules, implemented
in 22 states during the study, led to a 15 percent decline in the
use of those drugs and cut the average cost of all prescriptions
for pain pills called NSAIDs by $10.28.
``With nearly 18 million NSAID prescriptions covered by
Medicaid in 2003, this decrease can be projected to an annual
reduction in spending of $185 million,'' the researchers said.
The study, financed by the National Institutes of Health and
the Arthritis Foundation, was conducted before Merck recalled
Vioxx in September because of heart risks.
Limit Expense
The prior authorization was designed to limit use of the
more expensive drugs known as Cox-2 inhibitors to patients most
likely to benefit -- those with high ulcer risks.
Some of the reduction ``is simply the inconvenience of
having to do extra paperwork,'' said Michael A. Fischer, the lead
researcher from Brigham and Women's Hospital and Harvard Medical
School. ``The important question for the next set of studies is
figuring out if it affects the right patients.''
The findings should apply to treatments for a wide range of
conditions, not just pain medications. That will be important as
the federal government implements a prescription-drug benefit for
elderly Americans starting in 2006, Fischer said.
``These kinds of programs can be an effective tool for
containing costs,'' he said in a telephone interview. ``Every
time people take another look at projections for the drug
benefit, the costs go higher. Coming up with policies that are
going to contain the drug costs is going to have to be done.''
--Editor: Todd. |
