Louisiana Drug Utilization Review
The Louisiana Medicaid Pharmacy Benefits Management program uses several different drug utilization review (DUR) applications. The retrospective drug utilization review program in Louisiana is called LaDUR. The program, through a contract with the fiscal intermediary, Unisys, administers LaDUR as a component of its Drug Utilization Review (DUR) system. Rather than concentrate solely on the patient's prescription utilization, LaDUR focuses on the patient’s disease states.
Drug Utilization Review Board
The Louisiana Department of Health established a Drug Utilization Review Board to assist the agency in assessing its Drug Utilization Review Program.
DUR Board Functions:
- Make recommendations and approve predetermined criteria established in retrospective DUR and prospective DUR;
- Evaluate the use of predetermined criteria and standards in use, and make recommendations to the Bureau concerning modification or elimination of existing predetermined criteria and standards or the adoption of new ones;
- Recommend guidelines governing written predetermined criteria and standards that pharmacies not using approved software must use in performing prospective DUR;
- Identify educational topics to improve prescribing and dispensing practices;
- Make recommendations regarding interventions to improve quality of drug therapy;
- Periodically re-evaluate educational interventions;
- Be a knowledgeable group, dedicated to assisting the agency in the administration of its Drug Utilization Review program in an advisory capacity; and
- Prepare annual report.
LaDUR Board Membership
Federal statute specifies the general board membership. The membership of the DUR Board shall consist of at least one-third but not more that 51% licensed and actively practicing physicians and at least one-third licensed and actively practicing pharmacists. The committee shall be composed of at least eight members (or approved designees) appointed by the secretary of the Louisiana Department of Health.
The committee shall consist of health care professionals who have recognized knowledge in:
- Clinically appropriate prescribing of covered outpatient drugs;
- Clinically appropriate dispensing and monitoring of covered outpatient drugs;
- Drug use review, evaluation and intervention; and
- Medical quality assurance