Recommended reading from Anne Taylor-Vaisey: 1: J Clin Pharmacol. 2006 Apr;46(4):394-7. Clinical pharmacology of the appeals and exception process: the interface of the patient, physician, and insurance company to assure appropriate care under medicare part d. Blum RS.
Personalized medicine considers factors unique and specific to each patient to make clinical decisions, inclu ding selecting pharmacotherapy. Drug formularies, including those available to enrollees in Medicare Part D, are based on group characteristics and financial considerations. Consequently, an appeal of a formulary's preferred drug selection may be necessary to ensure the best care of the patient. Consideration of basic principles of clinical pharmacology can be used to decide whether an exemption should be considered and to document specific reasons for the request.
PMID: 16554444 [PubMed - in process]
Health Econ. 2006 Jan;15(1):5-18.
Pharmaceutical promotion and GP prescription behaviour.
Windmeijer F, de Laat E, Douven R, Mot E.
The aim of this paper is to empirically analyse the responses by general practitioners to promotional activities for ethical drugs by pharmaceutical companies. Promotion can be beneficial as a means of providing information, but it can also be harmful in the sense that it lowers price sensitivity of doctors and it merely is a means of maintaining market share, even when cheaper, therapeutically equivalent drugs are available. A model is estimated that includes interactions of promotion expenditures and prices and that explicitly exploits the panel structure of the data, allowing for drug specific effects and dynamic adjustments, or habit persistence. The data used are aggregate monthly GP prescriptions per drug together with monthly outlays on drug promotion for the period 1994-1999 for 11 therapeutic markets, covering more than half of the total prescription drug market in the Netherlands. Identification of price effects is aided by the introduction of the Pharmaceutical Prices Act, which established that Dutch drugs prices became a weighted average of the prices in surrounding countries after June 1996. We conclude that GP drug price sensitivity is small, but adversely affected by promotion. Ltd. Copyright (c) 2005 John Wiley & Sons, Ltd.