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Editorial
January 9, 2006

A Call for Fairness in Formulary Decisions

Arch Intern Med. 2006;166(1):16-18. doi:10.1001/archinte.166.1.16

In this issue of the ARCHIVES, Morgan DeWitt and colleagues1 demonstrate that an irrational prescription drug reimbursement policy (Medicare reimburses infliximab and not etanercept, even though etanercept is more convenient and less expensive) leads to undesirable clinical practice (Medicare patients are 30% more likely to receive infliximab than privately insured patients). Others2,3 have also shown that poor formulary decisions can lead to poor outcomes, yet drug formularies are increasingly seen by payors of prescription drugs as an essential aspect of drug policy.4,5 Why? In this editorial, we briefly describe the rationale for formularies and discuss aspects that are receiving increasing attention: the availability of information about the benefits and harms of drugs, how to involve the public in these difficult decisions, and the price of drugs.

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