The purpose of this study is to understand the effect of state generic substitution regulations on the generic prescribing and dispensing processes in the Medicaid program and describe the factors that influence dispensing and prescribing generic drugs. The primary research objective for this study is to calculate estimate the rates of generic substitution (i.e., "Generic Prescribing Rate", "Generic Dispensing Rate" and "Net Generic Rate") in the Medicaid program between 1991 and 2008 and to determine and understand how state regulations influence the process of prescribing and dispensing generic drugs in the state Medicaid programs. The research performs at the Substitutable Market level and explains the significant differences observed.The study design is a retrospective, cross-sectional time series study. Databases from the Centers for Medicare and Medicaid Service (CMS) and the "Medicaid State Drug Utilization Data" will be collected with four observations per year by state from 1991 to 2008. This data base was complemented with Medi-Span Master Drug Data Base ® (MDDB), Medi-Span Price-Check PC ®, National Association of Board of Pharmacy (NABP) publications and Medicaid Payment Data Base (MPDB).The data set for this study was the entire population of drugs reimbursed by therapeutic class in 48 states (excluding Arizona & Tennessee) since 1991 to 2008 in the Medicaid program. The descriptive analysis was performed nationwide and by state. However Fixed effects, two-stage least squares regression was utilized to analyze the regression models nationwide by therapeutic class.
University of Minnesota Ph.D. dissertation. December 2014. Major: Social and Administrative Pharmacy. Advisor: Stephen W. Schondelmeyer. 1 computer file (PDF); vii, 318 pages, appendices 1-6.
Sepulveda Adams, Daniel A..
Impact of pharmacy regulation and payment on generic drug use in the medicaid programs: 1991 to 2008.
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