The most common therapeutic intervention in medicine is thewriting of a prescription1. The proliferation of therapeuticalternatives and the growing recognition of the clinical andeconomic consequences of suboptimal pharmacotherapy2,3,4 havestimulated a variety of efforts to improve prescribing. Theseinclude physician-education programs,2,3 required drug-utilizationreview for patients covered by Medicaid,5 restrictive accesspolicies (formularies, service limitations, requirements forprior approval, and substitution requirements),6 and directfederal regulation of the indications for using prescriptiondrugs7. However, physicians, third-party payers, and regulatorsmust face a fundamental but rarely asked question: Are thereadequate data to guide choices among . . . [Full Text of this Article]
Address reprint requests to Dr. Wayne A. Ray at the Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232.
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