Drug Utilization Review
Overview...
Drug Utilization Review (DUR) promotes appropriate use of pharmaceuticals in the Medicaid/CHIP Vendor Drug Program through education of practitioners.
Clinical edits help ensure access to care through the therapeutically prudent use of pharmaceuticals and optimize the use of program funds.
The DUR Board meets quarterly to determine criteria for retrospective and prospective drug utilization.
Administration
Drug Criteria for Outpatient Use
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- Acetylcholinesterase Inhibitors
- Aerosolized Agents - Metered-Dose Inhalers: Anticholinergic Drugs
- Aerosolized Agents (Metered-Dose Inhalers) – Inhaled anti-inflammatory drugs: Corticosteroids
- Aerosolized Agents - Metered-Dose Inhalers: Beta2-Adrenergic Drugs (long-acting)
- Aerosolized Agents - Metered-Dose Inhalers:Beta2-Adrenergic Drugs (short-acting)
- Angiotensin-Converting Enzyme (ACE) Inhibitors
- Angiotensin II Receptor Antagonists - Losartan (Cozaar® )
- Antidepressant Drugs
- Antidiabetic Agents, Oral
- Antihistamines, Nonsedating
- Aprepitant (Emend® )
- Attention Deficit Disorder (ADD)/ Attention Deficit Hyperactivity Disorder (ADHD) Medications
- Atypical Antipsychotics
- Benzodiazepines
- Cyclooxygenase-2 (COX-2) Inhibitors
- Exenatide (Byetta®)
- Fentanyl Transmucosal Lozenges and Buccal Tablets
- Fluoroquinolones
- Dolasetron (Anzemet®), Granisetron (Kytril®), Ondansetron (Zofran®) - 5-Hydroxytryptamine Subtype 3 (5-HT3 ) Receptor Antagonists
- Gabapentin (Neurontin®)
- Histamine H2 - Receptor Antagonists
- HMG-CoA Reductase Inhibitors
- Hydrocodone Bitartrate
- Ketorolac (Toradol® ), Oral
- Leukotriene Receptor Antagonists
- Low-Dose Quetiapine
- Low Molecular- Weight Heparins(LMWH)
- Mecasermin
- Memantine (Namenda®)
- Nebulized Bronchodilators
- Nitazoxanide
- Nonsedating Antihistamines
- Non-Steroidal Anti-Inflammatory Drugs
- Pramlintide (Symlin®)
- Promethazine Use In Children < 2 Years of Age
- Proton Pump Inhibitors
- Rifaximin (Xifaxan®)
- Sedative/Hypnotics
- Serotonin 5-HT1B/1D Receptor Agonists
- Skeletal Muscle Relaxants
- Sucralfate (Carafate®)
- Topical Calcineurin Inhibitors: Elidel®, Protopic®
- Tramadol (Ultram® )
Resources
Early Drug Utilization lab is “hands-on” in developing criteria.