Kaiser Daily Health Policy Report Rounds Up States’ Prescription Drug Moves

The following is a summary of recent news on states' prescription drug plans:

• Colorado: A bill that would have established a preferred drug list for Medicaid beneficiaries has failed in the state's House Health, Environment, Welfare and Institutions Committee by a 7-4 vote, the Denver Post reports. The legislation would have set up a committee to select the "best and least expensive medicines for various diseases," and doctors would have been "encouraged" to prescribe drugs from that list but could use other medications "if they believe those are best." But some committee members were concerned that the proposal "wouldn't change doctor's prescribing habits" and that people with chronic diseases "could be hurt" because they might not receive the medications they need (Kane, Denver Post, 2/5).
• Maine: By restricting Medicaid beneficiaries to a formulary of 150 prescription drugs, Maine has saved about $15 million over the last year, NPR's "All Things Considered" reports. Maine is one of 35 states to restrict Medicaid beneficiaries' access to prescription drugs, but has been one of the more successful states to do so, NPR reports. Last year, Maine's Human Services Commissioner Kevin Concannon asked a committee of medical professionals to make a list of prescription drugs that could be replaced by cheaper alternatives and then told doctors to "avoid products on that list or convince state officials that the more expensive drugs are necessary." Concannon said that doctors sought approval for only one out of every 100 prescriptions; the state approved 90% of those requests. Although the Maine Medical Association has spoken against the restrictions, individual doctors "by and large" have "tolerated" it (Renner, NPR, "All Things Considered," 2/5). An audio file of this report is available online. Note: You must have RealPlayer to listen to the report.
• Nevada: Negotiations with the private company that administers the state's Senior Rx program have resulted in savings for the state, which could mean that more seniors will be allowed to enroll in the program, the Las Vegas Sun reports (Ryan, Las Vegas Sun, 1/30). Under Senior Rx, seniors with annual incomes of less than $21,500 per year are eligible to have up to $5,000 in prescription costs covered per year. Participants pay $10 per generic drug prescription and $25 per brand-name prescription. The state covers an annual premium of $1,280 per senior (Kaiser Daily Health Policy Report, 5/23/01). Nevada officials had planned to cap the program's enrollment at 6,000 -- the current enrollment level -- and set up a waiting list. The Sun reports that the state and the unnamed private company agreed to lower the state's current $106 per person per month cost; state officials said that they have not yet signed the final contract with the private company and do not know the final cost. Officials also are unsure how the renegotiated prices will affect the program's enrollment. Mike Willden, director of the state Department of Human Resources, said that before the state decides how many more seniors can enroll in the program, the department needs to find out how much the state's next portion of the national tobacco settlement, which pays for part of Senior Rx, will be (Las Vegas Sun, 1/30).
• Washington: A new initiative aimed at reducing prescription drug costs under the state's Medicaid program by limiting beneficiaries to four brand-name prescriptions per month took effect Feb. 1, the AP/Seattle Times reports (AP/Seattle Times, 2/1). Under the "Therapeutic Consultation Service" program, if a patient attempted to fill a fifth brand-name prescription in a month, the pharmacist would contact the beneficiary's physician, who would then have to contact a pharmacist hired by the state for approval. Besides granting or rejecting doctors' prescription requests, the pharmacists, provided six days per week by Atlanta-based Consultec, also will examine the patient's current prescriptions to "prevent duplications and dangerous interactions." Contraceptives, HIV medications, chemotherapy drugs, antidepressants and antipsychotics would be exempt from the four-drug limit (Kaiser Daily Health Policy Report, 10/2/01). The program -- the second of its kind in the country -- will cover 437,000 Medicaid beneficiaries. Doug Porter, state Medicaid director, said the state will save $30 million over the next year and a half by using the program. But some doctors have expressed concern that the program would save money at "doctors' and patients' expense." Washington State Medical Association President Dr. Sam Cullison said, "If I have a substantial Medicaid practice, the number of phone calls or faxes could be huge. [Doctors] are choking on hassles" (AP/Seattle Times, 2/1).