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Drug Utilization Review (DUR) Board

Background

The Oklahoma Medicaid Drug Utilization Review (DUR) Board was formed in the winter of 1992 to comply with Federal regulations contained in the Omnibus Budget Reconciliation Act of 1990 (OBRA 90). As a result of Oklahoma Senate Bill 470, administration of the DUR program was transferred in May of 1995 from the Department of Human Services to the Oklahoma Health Care Authority (OHCA).

Purpose

The DUR Board was established to advise OHCA about the appropriate and optimal use of pharmaceuticals for Oklahoma Medicaid recipients.

Goals

The primary goal of drug utilization review is to enhance and improve the quality of pharmaceutical care and patient outcomes by encouraging optimal drug use. This goal is accomplished primarily by educating physicians and pharmacists to ensure that drug therapy is appropriate, safe and effective.

Functional Activities

  • Making policy recommendations regarding medication coverage, which may include restriction of certain medication classes to be covered through the medication authorization program
  • Establishing and/or approving the criteria and standards for DUR
  • Developing and evaluating the Prospective DUR program
  • Developing and evaluating the Retrospective DUR program
  • Making recommendations concerning the appropriate mix of education and intervention approaches to be carried out as a result of medication therapy problems identified in the prospective and retrospective review process