Florida Legislature Passes Bill Increasing Access to Four Generic Drugs, Leading Health Policy Report Drug Round Up

The Florida Senate on May 2 approved a House-passed bill (HB 69) that would allow pharmacies to dispense the generic versions of four drugs that are currently on a list of 11 drugs that may not be switched with generic equivalents, the AP/Florida Times-Union reports. Under the legislation, the pharmacists would be permitted to substitute generics for the four drugs unless a physician "specifically orders" the brand-name prescription. The switch is expected to save the state's Medicaid program between $4 million and $8 million and save the private sector between $15 million and $20 million. Gov. Jeb Bush (R) is expected to "review the legislation" (Hallifax, Florida Times-Union, 5/2). A number of other state legislatures are weighing proposals to assist seniors and the uninsured with prescription drug costs. Measures under consideration in four states are summarized below.

• Arizona: With a 16-13 vote, the state Senate on May 1 passed a bill (SB 1118) that would help rural seniors pay for prescription drugs. Under the proposal, seniors between 150% and 250% of the federal poverty level, or those with an individual annual income between $12,885 and $21,475, would be eligible for a 50% discount on prescription drugs after spending from $500 to $1,000 out of pocket on medications. The measure, dubbed the "catastrophic" plan, will serve as a "two-year stopgap until Congress can add a prescription drug benefit to Medicare." The Arizona Republic reports that the state House on April 30 "killed a more expansive prescription drug bill (HB 2424) that included a federally negotiated discount on prescription drugs throughout the state." The measure has been sent to Gov. Jane Hull (R) for signing (Sherwood, Arizona Republic, 5/2).
• Massachusetts: The state House is considering two amendments that would reverse a House budget proposal to lower funding and eligibility levels for Prescription Advantage, the state's prescription drug coverage program for low and middle-income seniors, the Springfield Union-News reports. The House Ways and Means Committee's proposed budget changes would "raise copayments for most participants ... and double the deductibles participants must spend before becoming eligible." The budget proposal would also increase the amount from $2,000 to $4,000 that middle-income people would have to spend out of pocket annually to be eligible for the program and would remove an $82.50 cap on premiums for some beneficiaries. The two amendments would restore the program's previous funding level and eligibility terms (Lauerman, Springfield Union-News, 5/1).
• Nevada: The state Assembly on April 27 approved a measure (AB 545), sponsored by Assembly member Barbara Buckley (D), that would shift operation of Senior Rx, the state's prescription drug program for the elderly, away from private companies to the state, eliminate premiums for all seniors and reduce copayments for each prescription, the Las Vegas Sun reports. The program, funded by the state's tobacco settlement and operated by insurance companies, requires premiums starting at $74 per month for participants with the lowest incomes, who receive a $40 state subsidy. As such, only 300 of the 11,000 Nevada seniors eligible for the program have enrolled since its December launch. In addition to Buckley's proposal, the state Legislature is considering a plan (SB 239) from Gov. Kenny Guinn (R) that would eliminate premiums to boost program enrollment. Guinn's proposal has passed the state Senate in March and is now under consideration in the state Assembly (Las Vegas Sun, 4/27).
• Washington: Washington's AWARDS program, which provides prescription drug coverage for seniors, may not provide cost savings for participants unless they choose to fill their prescriptions by mail, the AP/Seattle Post-Intelligencer reports. The Tacoma News Tribune reported on April 29 that of the 25 drugs most commonly prescribed for seniors, only seven were least expensive under the AWARDS program, as seniors could "find lower prices by using senior discounts at chain or discount drug stores." The one "major advantage" the AWARDS plan offers is "significant" savings if seniors choose to have prescriptions filled by mail (AP/Seattle Post-Intelligencer, 5/1). An editorial in the Tacoma News Tribune criticizes the AWARDS program, charging that it "sqeeze[s]" the savings from the "slim" profit margins of drugstores. While the program was intended to offer savings of 12% to 30% for seniors who purchased drugs at participating pharmacies, the editorial says the program has failed to "deliver consistent savings." The editorial concludes: "It is simply not fair to demand that several hundred retailers assume the burden of financing a state social program that potentially benefits hundreds of thousands of Washingtonians. The fact that AWARDS doesn't offer much in the way of savings for many seniors is one more reason to scrap the program" (Tacoma News Tribune, 5/2).