Impact of NSAIDs prior authorization policy on patients’ Qol

BACKGROUND: In 1996, the West Virginia Medicaid program targeted nonsteroidal antiinflammatory drugs (NSAIDS) for prior authorization (PA) to ensure cost-effective and appropriate utilization. PA guidelines required that patients must have tried and failed treatment with 2 different classes of generic NSAIDs before a brand-name NSAID could be approved. OBJECTIVE: To evaluate the impact of the requirement of PA for branded NSAIDs on the health-related quality of life (HRQoL) of patients who are chronic users of NSAIDs. DESIGN: Pre- and postintervention quasiexperimental design was used for this study. The sample consisted of continuously eligible Medicaid recipients who were <65 years old and who were diagnosed with rheumatoid arthritis, osteoarthritis, spondylitis, or chronic pain syndromes. Data were collected through a mail survey using the abbreviated version of the Arthritis Impact Measurement Scales. RESULTS: A total of 181 (37.1%) completed surveys were received, 110 (39.2%) from the branded-NSAID user group and 71 (32.7%) from the generic-NSAID user group. Patients who were restricted to generic NSAIDs did not report deterioration in any of the HRQoL domains measured, including mobility, walking and bending, hand and finger function, self care, household activities, social activities, and tension. CONCLUSIONS: The requirement of PA for the use of branded NSAIDs did not compromise patients’ HRQoL at 8 weeks follow-up.