J Clin Outcomes Manage
Effects of a hospital formulary on outpatient drug switching
Sun BC, Bates DW, Sussman A
Abstract Objective: To assess the effect of an inpatient formulary on outpatient medication use. Design: Retrospective analysis of claims and administrative data. Setting and participants: Members of 2 capitated health care plans admitted to an academic tertiary care hospital in 2001–2002 who were using a proton pump inhibitor (PPI) or statin not on the hospital formulary within 3 months prior to hospitalization. Measurements: The primary outcome was postdischarge use of a hospital formulary PPI or statin. Results: In 2001–2002, there were 139 patients who accounted for 177 admissions. There were 192 cases of nonformulary, preadmission use of a PPI or statin. A PPI or statin was ordered during hospitalization in 22% (95% confidence interval [CI], 16%–28%) of eligible cases; virtually all of these patients received the inpatient formulary equivalent. A discharge prescription for a formulary PPI or statin was given in 8% (95% CI, 4%–11%) of eligible cases, although only 1 patient (0.5%; 95% CI, 0%–2%) filled such a prescription. Conclusion: These data suggest that an inpatient formulary has minimal effect on outpatient PPI or statin drug switching in a privately insured, managed care population.
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