Prescription Drugs: HCFA's Proposed Drug Utilization Review System Ignores Quality of Care Issues
GENERAL ACCOUNTING OFFICE WASHINGTON DC PROGRAM EVALUATION AND METHODOLOGY DIV
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Most elderly individuals find that prescription drugs, as well as over-the-counter drugs, are critical to the overall effectiveness of their health care. In a recent report from the Office of the Surgeon General, drugs have been called an essential component of preventive and curative strategies in health care. Current research clearly indicates that prescription practices for the elderly need to be specifically targeted to them because of especially adverse drug reactions they may have. These reactions can lead to drug-induced illness, hospitalization, and even death for them. The Medicare Catastrophic Coverage Act of 1988 covers outpatient prescription drug costs for an estimated 17 percent of the elderly and provides a mechanism for checking the safety of drugs for all the elderly who use a participating pharmacy. This mechanism is an electronic drug utilization review DUR system for prescriptions at the point- of-sale. Such review is a formal program for assessing data on drug use against explicit, prospective standards and, as necessary, introducing remedial strategies to achieve some desired end. A point-of-sale DUR performs this check by linking the prescription-dispensing pharmacy electronically to a central computer drug file and screening for information on possible adverse interactions before the prescription is filled.