Study finds Medicaid drug selection COI policies vary, may be inadequate

Study finds Medicaid drug selection COI policies vary, may be inadequate
February 11, 2013 - 11:29am

How well do states’ policies address possible conflicts of interest of committee members who decide which drugs get Medicaid reimbursement? The question looms especially large as impending federal health care reform increases the number of patients covered by the state-run drug formularies.

A new study co-authored by Lisa Bero, PhD, faculty member in the UCSF School of Pharmacy's Department of Clinical Pharmacy, and published online today in JAMA Internal Medicine, finds wide variations in such conflict-of-interest (COI) policies that suggest some may not adequately protect against pharmaceutical industry influence.

Indeed, the study, co-authored with Nicole Nguyen, PharmD (while she was a UCSF student pharmacist), found that current polices are neither transparent nor standardized: only 27 states’ policies were publicly available, and the requirements included a mixture of strategies ranging from COI disclosure alone, to self-recusals, to banning some or all industry relationship by committee members.

Such policies are important, Bero notes in a podcast that will accompany the study, because a previous study of hospital formulary committees found that “members who have more interaction with drug companies are more likely to request that drugs made by that company be added to the formulary.”

COI policies need to be improved and standardized, she notes, because “decisions about what goes on Medicaid preferred drug lists ... should be based on the best available evidence and free of conflicts of interest.”

Read the study:

Medicaid Drug Selection Committees and Inadequate Management of Conflicts of Interest

The School of Pharmacy at UC San Francisco (UCSF) is a prominent academic institution, founded in 1872, that today pioneers the health sciences graduate-level education, biomedical research, and patient care needed to further the development and best use of precise therapeutics—medications, medical devices, and diagnostic tests—to improve the health of people everywhere. The School is an integral part of UCSF, the nation’s leading university exclusively focused on health.