Nightengale B, Reeder C E
College of Pharmacy, University of South Carolina, Columbia.
Clin Ther. 1993 May-Jun;15(3):581-92.
The Omnibus Budget Reconciliation Act of 1990 (OBRA-90) may be the most significant piece of legislation affecting the practice of pharmacy since the Durham-Humphrey amendments to the Food, Drug and Cosmetic Act. As part of the OBRA-90 legislation, the Health Care Financing Administration (HCFA) was required to publish estimates of the impact of the act on states, Medicaid recipients, and pharmacies. Numerous stakeholders and researchers have commented on the HCFA estimates. We have summarized the estimates available in comments and studies and conducted a sensitivity analysis on these estimates. Our results demonstrate considerable variation in the factors important in estimating the impact of OBRA-90 on pharmacy operations. This variation indicates the scarcity of empirical data needed to produce reliable impact estimates. Demonstration projects are needed to scientifically evaluate the total impact of OBRA-90 on pharmacy practice. Moreover, further investigation of the impact of the legislation on program recipients and states is warranted.
1990年《综合预算协调法案》（OBRA - 90）可能是自《食品、药品和化妆品法案》的达勒姆 - 汉弗莱修正案以来，影响药学实践的最重要的一项立法。作为OBRA - 90立法的一部分，医疗保健财务管理局（HCFA）被要求公布该法案对各州、医疗补助接受者和药房影响的估计。众多利益相关者和研究人员对HCFA的估计发表了评论。我们总结了评论和研究中可用的估计，并对这些估计进行了敏感性分析。我们的结果表明，在估计OBRA - 90对药房运营影响方面重要的因素存在相当大的差异。这种差异表明，要得出可靠的影响估计所需的实证数据非常稀缺。需要开展示范项目来科学评估OBRA - 90对药学实践的总体影响。此外，有必要进一步调查该立法对项目接受者和各州的影响。
