The Drug Utilization Review Board (DUR) is a requirement of the
Social Security Act, Section 1927 and operates in accordance with Nevada
Medicaid Services Manual, Chapter 1200 – Prescribed Drugs and Nevada Medicaid
Operations Manual Chapter 200. The DUR Board consists of no less than five
members and no more than ten members appointed by the State Director of Health
and Human Services. Members must be licensed to practice in the State of
Nevada and either an actively practicing physician or an actively practicing
pharmacist.
The DHCFP Chief of Pharmacy Services serves as
Coordinator to the DUR Board.
The DUR Board meets quarterly to monitor drugs for:
- therapeutic
appropriateness
- over
or under-utilization
- therapeutic
duplications
- drug-disease
contraindications
- quality
care
The DUR Board does this by establishing prior
authorization and quantity limits to certain drugs/drug classes based on
utilization data, experience, and testimony presented at the DUR Board
meetings. This includes retrospective evaluation of interventions, and
prospective drug review that is done electronically for each prescription
filled at the Point of Sale (POS).
Meetings
are held quarterly and are open to the public. Anyone wishing to address the
DUR Board may do so. Public comment is limited to three minutes per
speaker/organization (due to time constraints). Anyone presenting documents for
consideration must provide sufficient copies for each board member and a copy
(electronic preferred) for the official record.