Wide Variation in COI Policies in Medicaid Drug Selection
High variability in policies; inconsistency in enforcement, management of conflict of interest
TUESDAY, Feb. 12 (HealthDay News) -- Current Medicaid drug selection committees' conflict of interest (COI) policies are neither standardized nor transparent, and are marked by considerable variation, according to a study published online Feb. 11 in JAMA Internal Medicine.
Nicole Yvonne Nguyen, Pharm.D., and Lisa Bero, Ph.D., from the Institute for Health Policy Studies in San Francisco, examined Medicaid drug selection COI policies in all states with Medicaid Preferred Drug Lists (47 states plus the District of Columbia). The content of the policies was analyzed and data were extracted on COI disclosure parameters, management strategies, and review processes based on predefined categories, modified via an iterative process.
The researchers obtained policy documents for 56 percent of the programs; policy documents were obtained from Web sites and by contacting Medicaid officials. Among states, there was considerable variability in COI policies, lack of public availability, and inconsistency in enforcement and management of COI. Management strategies included disclosure of COI (67 percent of policies) and self-recusal (52 percent of policies). Certain relationships with industry were banned in a minority of policies (15 percent).
"Our findings help inform decision makers about COI issues that are relevant within the setting of drug selection," the authors write. "As health care reform is implemented and the number of Medicaid patients is expected to grow, drug selection for this population should be guided by the best available evidence and free from influence of COI."