Impact of a Uniform Formulary on Military Health System Prescribers: Baseline Survey Results
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Pharmaceuticals represent one of the fastest growing components of both U.S. civilian and Department of Defense (DoD) health care expenditures. Both the DoD and U.S. Congress have identified the Military Health System pharmacy benefit as an area for reform. To this end, federal legislation requires the DoD to establish a single uniform formulary (UF) of covered drugs governing beneficiaries' access to pharmaceuticals. The legislation also requires a baseline survey conducted prior to UF implementation and a follow-up post-implementation survey. The baseline survey that is the subject of this study gauged prescribers' experiences with and perceptions of drug formularies. The study assessed their opinions about the impact of formularies on clinical decisions, aggregate cost, and quality and accessibility of health care. Two groups of TRICARE prescribers were sampled-direct-care providers within military treatment facilities and providers at network (purchased-care) facilities. Differences were observed within each sample. For example, most direct-care prescribers reported a high degree familiarity with their respective formularies and formulary management practices and perceived formulary management as contributing toward quality of care, whereas most purchased-care respondents reported less familiarity with formulary lists and the rules governing their use and did not believe that formulary management contributes to quality of care.
Table of Contents
Errata (released February 23, 2004)
Summary
Preface
All Prefatory Materials
Chapter 1
Introduction
Chapter 2
Study Background
Chapter 3
Survey and Sample Design
Chapter 4
Data Collection and Response Analysis
Chapter 5
Summary of Findings (includes corrections)
Chapter 6
Conclusions
Appendix A
Survey Materials for Direct-Care Prescribers
Appendix B
Survey Materials for Purchased-Care Prescribers
Appendix C
Coefficients and Odds Ratios Used in the Non-Response Analysis
Appendix D
Detailed Data on Survey Responses
Appendix E
Comments from Survey Respondents
Supplemental
Supplementary Material
Research conducted by
The research described in this report was sponsored by the Office of the Secretary of Defense (OSD). The research described in this report was sponsored by the Department of Veterans Affairs (DVA). The research was conducted jointly by the RAND Health Center for Military Health Policy Research and the Forces and Resources Policy Center of RAND's National Defense Research Institute, a federally funded research and development center.
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