Florida Medicaid Disease Management Program Run By Pfizer Off to ‘Slow Start’

The disease management program operated by Pfizer Inc. under Florida's Medicaid program is off to a "slow start," according to an analysis by the state Agency for Health Care Administration, the AP/Orlando Sentinel reports. The state had hoped to enroll 12,000 Medicaid beneficiaries with diabetes, asthma, heart disease or high blood pressure, but only about 33% of the target enrollment had been reached as of March 12 (AP/Orlando Sentinel, 3/24). The program, called Florida: A Healthy State, began last June when Pfizer and state officials reached a deal to include the company's drugs on the state's Medicaid formulary without the drug company having to offer the state additional price rebates. Under the two-year deal, Pfizer agreed to provide disease management services to certain chronically ill Medicaid beneficiaries and promised to save the state $15 million in Medicaid costs during the first year and $18 million during the second year. If the company does not save the state a combined $33 million over the next two years, it has agreed to pay the state the difference in cash (Kaiser Daily Health Policy Report, 3/13). Although enrollment in the program is not meeting officials' expectations, sales of Pfizer drugs to Medicaid beneficiaries has increased since the program began, according to the state's review. In the last quarter of 2001, sales of Pfizer's top drugs under the Medicaid program increased 15%, or $3 million, compared with the quarter before the formulary was implemented. During the same time period, prescriptions for Pfizer drugs increased 17% under the Medicaid program. If the trend continues, the AP/Sentinel reports that Pfizer drug sales under Florida's Medicaid program will be up about $12 million this year. Because the disease management program is not faring as well as drug sales, the AP/Sentinel reports that the state likely will not reach its savings goal, and Pfizer will need to cover the difference in cash (AP/Orlando Sentinel, 3/24).