Formulary Restrictions Inhibit Medication Adherence

Krishna R. Patel, PharmD, RPh

If you haven’t already heard about the negative impact of formulary restrictions on adherence, well here it is. With mixed messages regarding formulary restrictions’ impact on patients, a recently published systematic literature review, published by Happe, et al., sought to get to the bottom this.

It analyzed 93 studies published in 1993 or later and found that formulary restrictions have a negative impact on medication adherence. Seeing this makes me wonder if formulary restrictions, which are intended to cut cost, actually lead to increased overall cost. I would say it’s not so much because of the fact that formulary restrictions exist as it is because of how they are implemented. For example, it’s known that prior authorizations are the bane of physicians' and patients’ existences alike. But don’t you think that patients would be a little more adherent if the process were not so onerous?

Thank goodness formulary decision makers are here to abate costs, but there is always room for process improvement. Amidst  health care costs that never seem to cease growing, could formulary restrictions actually be fueling the problem?

Krishna R. Patel, PharmD, RPh, is an adjunct faculty member at Philadelphia College of Pharmacy.