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Further, changes in formulary tier-design and related increases in copayments were associated with reductions in medication use and increased out-of-pocket spending by patients.
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There was a rapid rise in risperidone use towards the final quarter of 2003 and later, which followed a change in formulary status of risperidone.
Other researchers have shown significant increases in usage and costs occurring with changes in AP formulary reimbursement strategies [ 42- 45].
A small retrospective study recently evaluated outcomes in patients (n = 10 with type 1 diabetes and n = 21 with T2DM) switching from insulin glargine to insulin detemir due to changes in Medicaid formulary coverage [ 15].
The change in the formulary status of risperidone was associated with an increase in prescribing.
In addition, changes in health plan formularies, pharmaceutical advertising, and concerns about resistance to standard therapies may have influenced these prescribing trends.
A second objective was to examine whether use of gatifloxacin and/or moxifloxacin was associated with increased rates of C. difficile infection in healthcare facilities and to assess whether outbreaks correlated with formulary changes in fluoroquinolones.
11 12 13 14 Increased efficacy was observed on a population level when patients in a managed care plan were systematically switched from latanoprost to bimatoprost therapy following changes in the HMO's pharmacy formulary.
A systematic review also found that meetings with representatives were associated with requests by physicians for promoted drugs to be added to the hospital formulary, requiring changes in prescribing practice with increased prescribing costs and less rational prescribing [ 11].
Although good infection control practices are the most important measure in limiting the spread of resistance, other measures are required, including changes in antimicrobial drug prescribing patterns through formulary modification and enhanced education of prescribers (5 ).
In 2009 this necessitated a change in the antimicrobial formulary to cover this MDR E. coli both for bacteraemia, with the urinary tract as the potential source, and also treatment for cystitis.
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