The Formulary Process

1. The goal of the formulary is to:

Carry a greater variety of drug products.
Develop more detailed knowledge of drug products.
Encourage more effective use of drug therapies.
Ensure appropriate physician feedback to the P&T Committee.

2. Which of the following statements is true?

Medicare is the single largest purchaser of prescription drugs.
To reduce costs, some HMOs request bid prices from competing managed care organizations for therapeutically similar drugs.
Physicians who contract with several different managed care plans tend to prescribe from the least restrictive formulary.
Formularies affect patients in long-term care institutions such as nursing homes.

3. In general, formulary policies tend to influence physicians' prescribing practices through:

Incentives.
Mandates.
Legislation.
Decision Analysis.

4. Information gathering during the formulary approval process generally involves the use of all the following except:

A literature search.
Patient surveys.
Pharmacoeconomic research.
Drug use evaluations.

5. In a ________________ study, patients are monitored on an ongoing basis, with data gathered during the study period.

Retrospective
Redundancy
Modeling
Prospective

6. The use of _______________ has been linked to higher utilization of other healthcare resources and higher overall patient costs.

Therapeutic interchange
Electronic prescribing
Restrictive formularies
Generic drugs

7. Which of the following statements is false?

Most HMO physicians will have their drug utilization monitored to some extent.
The drug utilization evaluation process can have a significant impact on healthcare representatives' relationships with physicians.
Drug utilization evaluations are usually conducted by special outside consultants.
Drug utilization evaluation is often applied to high-risk drugs.

8. Clinical practice guidelines are often developed by:

The managed care administrator.
The Academy of Managed Care.
The drug utilization review committee.
The P&T Committee.

9. Which of the following groups is not considered a PBM payer?

Patients.
Managed care organizations.
Employers.
Insurance companies.

10. Counterdetailing refers to:

Educational interventions to promote formulary guidelines.
Using compiled claims data to prepare customized reports.
Transmitting information about member eligibility, benefit coverage, and drug pricing.
Channeling prescriptions to mail-order pharmacies.

11. In contracting with a GPO, the pharmaceutical manufacturer agrees to a _________ contract in exchange for ___________.

Nonexclusive, formulary acceptance
Limited-duration, physician-driven advertising
Managed care, outcomes research
Volume-driven, formulary considerations

12. Which of the following is not a key source of information about an institution's formulary?

HMO bulletin board.
In-house pharmacy newsletter.
Competitor Web site.
Health plan Website.

13. The primary criteria used in assessing products for formulary approval are safety, cost and:

Fairness.
Reimbursement.
Efficacy.
Abuse potential.

14. To maintain your product's place on the formulary, you should provide the P&T committee with:

Requests for increased patient monitoring.
Formulary information from other healthcare institutions.
The latest study results regarding your product.
A list of your product's competitors that are currently on the formulary.

15. Pharmacoeconomic data and ________________ are particularly important areas to improve upon when reapplying for formulary acceptance.

Outcomes research
Quality-of-life data
Value-added programs
FDA compliance
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