Florida Makes Medicaid Formulary Deal with Bristol-Myers, Similar to Pfizer Agreement
Bristol-Myers Squibb Co. on Sept. 5 reached an agreement with the Florida Agency for Health Care Administration to establish community-based preventive health care programs that will save the state a "guaranteed" $16.3 million over the next two years, the Wall Street Journal reports. Under the agreement, Florida will place all of the company's medications on the state's new Medicaid drug formulary (Gold, Wall Street Journal, 9/6). A Florida law passed in May requires pharmaceutical companies to provide discounts in order to have their drugs placed on the formulary (Kaiser Daily Health Policy Report, 8/8). However, under the agreement, Bristol-Myers was able to "avoi[d]" offering the "steep" rebates that the state asked for in exchange for inclusion on the formulary. Instead of offering discounts, the drug maker will fund the hiring of health professionals and social workers to treat Hispanic and African-American Medicaid beneficiaries with depression and HIV/AIDS, as well as breast, cervical and lung cancer. In addition, Bristol-Myers will fund the hiring and training of community residents to help address language and cultural barriers that may prevent beneficiaries with heart disease and depression from receiving care. The company predicts that the programs will prevent "costly" emergency room visits and hospital stays and save Florida $16.3 million. Bristol-Myers will pay for the difference if the program saves the state less than that amount. "Our objective was to find a way to help patients get unrestricted access to our medicines" while saving Florida money on Medicaid, a Bristol-Myers spokesperson said (Wall Street Journal, 9/6). Last year, Florida's Medicaid program spent $59.6 million, or 4.4% of Medicaid drug spending, on Bristol-Myers medicines (Skidmore, Florida Times-Union, 9/6).
Negotiations
Florida is negotiating with two other unnamed drug companies, AHCA Secretary Dr. Rhonda Medows said (AP/New York Times, 9/6). However, state Medicaid Director Bob Sharpe said that future deals would have to be "particularly innovative" for the state to agree to them. Pfizer Inc. reached an agreement with the state similar to the Bristol-Myers deal in June (James, Miami Herald, 9/6). In August, the Pharmaceutical Research and Manufacturers of America filed suit against Florida in federal court in Tallahassee, arguing that the state's Medicaid formulary violates a federal statute requiring states to offer all prescription drugs to Medicaid beneficiaries "unless there is a written finding that the drug offers no clinically meaningful benefit" (Kaiser Daily Health Policy Report, 8/8). The court has not scheduled a hearing for the case (Wall Street Journal, 9/6). For further information on state health policy in Florida, visit State Health Facts Online.
