%0 Journal Article
%T Comparing the Medicaid Prospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies in 2015 and 2016
%A Johan S. Loaiza
%A Sergio I. Prada
%J Archive of "American Health & Drug Benefits".
%D 2019
%X The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR process and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR involving ongoing, periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug¨Cdrug interaction, and medically unnecessary care, and implement corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure the prescription drug cost-savings generated from its DUR programs annually, but it provides no methodology for doing so. An earlier article compared the methodologies used by states to measure cost-savings in their retrospective DUR program in fiscal years 2014 and 2015
%K cost-avoidance
%K cost-comparison
%K cost-savings
%K Medicaid Drug Utilization Review program
%K methodology transparency
%K prospective review
%K retrospective review
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404806/