Drug Utilization Review

Board Meetings
DUR Archived Meetings
DUR Newsletters
Retrospective DUR and Lock-in
Speaker Sign Up Process
Speaker Disclosure Form 

 The primary objectives of Drug Utilization Review (DUR) are to improve the quality of health care for Medicaid members and to assist in containing health care costs. In order to achieve these goals, prescription claims must be reviewed both prospectively and retrospectively. Findings of the reviews are communicated to both prescribers and pharmacists to assure that medications provided are appropriate, medically necessary, and not likely to result in adverse medical effects. Drug Utilization Review is mandated by the Omnibus Budget Reconciliation Act of 1990 (OBRA ’90), an amendment to the Social Security Act.

The Drug Utilization Review (DUR) Board is responsible for the establishment of standards and criteria for the prospective and retrospective DUR programs. The DUR Board is charged with making recommendations for educational interventions to prescribers and pharmacists to identify and reduce overuse, abuse, fraud, and inappropriate or medically unnecessary care. Health Information Designs, LLC (HID) assists the pharmacy program in conducting population-based educational interventions, approved by the DUR Board, for both medical prescribers and pharmacy providers.

Drugs or drug classes which are reviewed and found to be inappropriately utilized or have significant safety concerns are deemed candidates for prior authorization. These reviews are considered by the DUR Board and appropriate criteria for approval are determined by them, with input from medical and pharmacy providers, drug manufacturers, and other experts.

 Members

​Lester Labus, MD, Chair ​Michael Lonsinger, PharmD
​Kc Lovin, PA-C, Vice Chair ​Ernest Miller, DO
​C.K. Babcock, PharmD ​Mary Nemeith-Pyles, MSN, RN, CS
​Christopher Booth, PharmD ​Christopher Terpening, PharmD
​Scott Brown, RPh ​John Vanin, MD
​Myra Chiang, MD
Kate Forman, PharmD

 

 

350 Capitol Street | Room 251 | Charleston, WV 25301 | Phone: (304) 558-1700 | Contact Us | Site Map

Privacy, Security and Accessibility | WV.gov | USA.gov | © 2017 State of West Virginia