PDB68 The Impact of Implementing a Drug Preauthorization Policy in a Primary Care Setting

N Triki, S Shani, D Mossinson, D Greenberg

Research output: Contribution to journalMeeting Abstractpeer-review


We analyzed the impact of implementing a preauthorization policy for Rosiglitazone (an anti-diabetic drug) use on the eligibility requirements (treatment initiation and discontinuation) and patients' HbA1c levels.
We compared treatment patterns of diabetic patients prior to and after an implementation of a preauthorization policy for Rosiglitazone use. Data were obtained from the Maccabi Healthcare Services' (the second largest HMO in Israel) registry of diabetic patients. We compared adherence to eligibility criteria in a group of patients who received Rosiglitazone without preauthorization (N=1362) and patients who received the medication with preauthorization (N=824). The criteria for receiving Rosiglitazone in both groups were identical and included prior medication [experienced patients who received drug from the sulphonylurea class in combination with Metformin for at least a three months period], and laboratory criterion [HbA1c levels higher than 8% during the past three months]. Treatment should be continued only if within three months from treatment initiation, the patient acquired at least three packages of Rosiglitazone and a decrease of >0.8% in HbA1c values was observed.
Implementing preauthorization policy increased the fulfillment of the eligibility criteria (medication and laboratory) for drug use by 41% [from 25% of patients without preauthorization to 35% with preauthorization (p<0.001)]. With regard to meeting the requirements for treatment continuation after a three month period, there was an increase of only 6.4% in the fulfillment of both requirements (from 37.6% to 40.0% prior and after preauthorization, respectively). The average decrease in patients' HbA1c levels was 0.6% and was similar in both patients with and without preauthorization.
Implementing preauthorization for Rosigitazone resulted in an increase in meeting the requirements for treatment initiation and a marginal change in treatment continuation criteria, but this increase was insufficient to achieve HbA1c target levels. However, patients' health was not negatively affected by this policy.
Original languageEnglish
Pages (from-to)A484
JournalValue in Health
Issue number7
StatePublished - Nov 2011


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