Using Evidence in Formulary Decisions: The Employer's Perspective

With prescription drug costs rising each year in the double digit range, employers are seeking new strategies to control the dollars spent on the pharmacy benefit. Some employers are promoting appropriate prescription drug use by basing their prescription drug benefit plan design on the principles of evidence-basd medicine (EBM). EBM is the explicit, judicious and conscientious use of current beswt evidence from health care research in making decision about he care of individuals and populations. Evidence-based madicine offers many advantages. For example, its application shoud lead to improved quality of care for individuals and the population overall. But a lack of understanding and explanation of applications make successful implementation difficult. In a recent survey and focus group of selected large Chicago-area employers, all survey and focus group participants believed that using EBM and economic principles in plan design decisions would lead to reduced costs and healthier employees. Barriers to implementation ranged from union negotiation issues to senior management buy-in.