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

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

About the School: The UCSF School of Pharmacy is a premier graduate-level academic organization dedicated to improving health through precise therapeutics. It succeeds through innovative research, by educating PharmD health professional and PhD science students, and by caring for the therapeutics needs of patients while exploring innovative new models of patient care. The School was founded in 1872 as the first pharmacy school in the American West. It is an integral part of UC San Francisco, a leading university dedicated to promoting health worldwide.