Health Affairs

Health Affairs, 26, no. 3 (2007): 800-807 doi: 10.1377/hlthaff.26.3.800 © 2007 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Impact Of Medicaid Prior Authorization On Angiotensin-Receptor Blockers: Can Policy Promote Rational Prescribing?

Michael A. Fischer, Niteesh K. Choudhry and Wolfgang C. Winkelmayer

Prescription drug cost containment is a key health policy priority. State Medic-aid programs have implemented policies requiring prior authorization before paying for angiotensin-receptor blockers (ARBs), a costly class of blood pressure medications. We examined the impact of these policies on drug use. We found that policies using a stepped-therapy approach reduced ARB use by 1.6 percent when first implemented and decreased the subsequent trend in ARB use by 1.3 percent per quarter; alternative approaches were unsuccessful. These findings have important implications for the development of rational drug reimbursement policy under Medicare Part D and other health insurance plans.

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