Drug Utilization Review (DUR) Board Meeting Summary - May 24, 2007

Board Meeting of May 24, 2007:

Changes in pharmacy reimbursement were presented to the Board as well as a new edit for dual eligible Medicare/Medicaid enrollees for supplies claims. Project summaries prepared by Albany College of Pharmacy interns included potassium-sparing diuretics, ACE/ARB, and HIV patients. These summaries were evaluated at the meeting. A target date for transition of DUR to OHIP was announced as mid-July. An overview of DUR Operations from 1993 inception to the present, the need for a DUR program and an outline of the ProDUR process were presented.

Changes in pharmacy reimbursement enacted as part of the 2007-08 Executive Budget were presented to the DUR Board as well as a new edit for dual eligible Medicare/Medicaid enrollees for claims for medical supplies.

2006 Centers for Medicare and Medicaid Services (CMS) DUR Outcome Report:

The CMS DUR Outcome Report noted that through 7,855 DUR educational intervention letters, $2,967,903 in pharmacy cost savings was realized and $4,864,853 in medical cost savings was achieved. The total 2006 DUR cost savings attained was $7,832,756.

Antipsychotic Duplicate Therapy Project Outcomes Update:

Duplicate therapy interventions appeared successful as the number of identified physicians who met the original criteria decreased from 62 to 12, and the number of identified patients decreased from 290 to 55.

Elidel / Protopic Criteria Outcome Update:

As a result of the January 2007 implementation of the Elidel/Protopic criteria, the daily average of prescriptions decreased from 180 to 114 prescriptions per day in March 2007.

Meeting Summary Posted 5/18/09