Formulary submission guidelines for US managed care

Abstract

U S managed-care organisations (MCOs) are increasingly viewing formulary submission guidelines as a key management tool for cost and quality control. Blue Cross Blue Shield in Colorado and Nevada are among a number of US health plans introducing such guidelines for the drug industry to follow. At the inaugural European conference of the International Society for Pharmacoeconomics and Outcomes Research [ Cologne, Germany; December 1998 ], Professor Paul Langley from the University of Colorado Health Sciences Center in Denver, US, discussed the rationale for, and content of, these guidelines. He addressed some of the trends in the US healthcare sector, the issues of risk management in health systems and how these guidelines, along with pharmacoeconomic evaluation, can help manage risk.