Drug Utilization Review (DUR)

Drug utilization review programs help to ensure that prescriptions for outpatient drugs are appropriate, medically necessary, and not likely to result in adverse medical consequences. DUR programs use professional medical protocols and computer technology and data processing to assist in the management of data regarding the prescribing of medicines and the dispensing of prescriptions over periods of time.

The DUR Board provides clinical guidance to the Commissioner of Health regarding the utilization of pharmaceuticals and the evaluation of drug expenditures within the New York State Medicaid program.

DUR Board activities include but are not limited to the following:

  • Establishment and implementation of medical standards and criteria for the prospective and retrospective DUR program,
  • Development, selection, application, and assessment of educational interventions for physicians, pharmacists and recipients that improve care,
  • Administration of pharmacy programs, including the Preferred Drug Program and the Clinical Drug Review Program, and
  • Evaluation of drugs which may be responsible for exceeding the Medicaid Drug Cap or identified as a high-cost drug or gene therapy.

The DUR Board is authorized to provide recommendations to the Commissioner of Health.

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