Vendor Drug Reports

States are required on an annual basis to report their prescribing habits, cost savings generated from their DUR programs, and their program’s operations, including adoption of new innovative DUR practices via the Medicaid Drug Utilization Review Annual Report Survey.

 

Drug Utilization Review Annual Report

Drug Use and Expenditure Patterns

Rider 24 – Prescription Drug Rebate Program

The Annual Performance Report for the Prescription Drug Rebate Program details the outstanding prescription drug rebate balances for the Texas Medicaid, CHIP, KHC, and CSHCN Services Programs.

Rider 49 – Strengthening the Texas Medicaid Drug DUR Program

The Strengthening the Texas Medicaid Drug Utilization Review Program presents the strategies implemented by the agency to improve the Texas Medicaid Drug Utilization Review (DUR) Program.

Drug Pricing/Pharmacy Reimbursement Methodology

Delimited Text Files

The following text files have been created using semicolons to delimit, or separate, each column of text.  These files are of little use unless they are converted into some form suitable for analysis and study.  Most database and spreadsheet programs are able to read data that is saved in a delimited format.

Medication Therapy Management (MTM)

Medication therapy management (MTM) is a service, provided by pharmacists in collaboration with physicians and other healthcare providers, to enhance a patient’s knowledge of medications and increase adherence to prescription medication regimens, and also to detect potential adverse drug events and patterns of over-use or under-use of prescription drugs. MTM is provided to actively manage overall drug therapies and may consist of medication reviews, pharmacotherapy consults, disease management support, drug therapy management, drug safety surveillance, and health and wellness education.

Phase I

Rider 49, 82nd Legislature, 2011, required HHSC to implement a MTM pilot program aimed at reducing adverse drug events and related medical costs for a subset of high-risk Texas Medicaid clients with a hypertension diagnosis who are on four or more chronic medications. The interim report is a summary of the first five months of the MTM pilot program operation and includes interim data and outcomes. The interim report focuses on pharmacy and client enrollment; patient’s needs and corresponding MTM interventions; the outcome of the interventions; and estimated cost savings for the reporting period (April 27, 2012, to September 19, 2012). MTM services for clients with hypertension ended in 2013, and a final report will be produced in 2014.

Phase II

Rider 45, 83rd Legislature, 2013, expanded MTM services to patients with high risk asthma or chronic obstructive pulmonary disease (COPD) who are on four or more chronic medications. An interim report and final report will be produced following the conclusion of this phase in December 2014.