Chapter 13 | Managed Care

Question 1

Effective drug therapy is a cost-effective and highly valuable means of controlling total healthcare expenditures and improving quality of life.

Answer 1

True

Question 2

Drug utilization review (DUR) programs have traditionally been used to ensure the appropriate, safe, and effective use of prescription drugs, but are increasingly shifting their focus to minimize costs.

Answer 2

True

Question 3

DUR programs involve retrospective monitoring of physicians’ prescribing patterns.

Answer 3

True

Question 4

A formulary is a list of prescription drugs approved by insurance coverage.

Answer 4

True

Question 5

The history of drug formularies in the U.S. extends back to _________.

Answer 5

the American Revolution

Question 6

Which of these is not a type of formulary: a)closed three-tier in which generic drugs are listed on Tier 1
b) five-tier that is supplemented by a step therapy program
c) open that replaces few restrictions on coverage or access
d) all of these are types of formularies

Answer 6

d) all of these are types of formularies

Question 7

The repeal of Hatch-Waxman is a recent formulary trend.

Answer 7

False

Question 8

What did the Hatch-Waxman Act do?

Answer 8

Make it easier for generic manufacturers to compete with R&D companies.

Question 9

What is opportunity cost?

Answer 9

The value of a sacrificed alternative.

Question 10

The three primary entities that fund pharmaceuticals are employers, the government, and ______________.

Answer 10

Individuals

Question 11

A company’s medical liaison can be a member of a P&T committee.

Answer 11

False

Question 12

Almost 98% of employed Americans are now covered by a HMO, a preferred provider organization, or a point-of-service plan.

Answer 12

True