Massachusetts Group Recommends Limiting Medicaid Drugs; Michigan Lawmakers Propose Formulary Changes
Implementing "tighter controls" on drug prescriptions for Medicaid beneficiaries and purchasing medications in bulk topped a list of recommendations from a Massachusetts House "working group" tasked with trimming costs from the program, the Springfield Union-News reports. The group, created in January by state House Speaker Thomas Finneran (D), noted in a report released April 10 that requiring doctors to receive approval before prescribing brand-name drugs to Medicaid beneficiaries would save the state $30 million per year (Lauerman, Springfield Union-News, 4/11). Adding in a requirement that beneficiaries contribute copayments for medications would save the state $100 million, according to the report. The state spent $4 billion on Medicaid last year, accounting for 20% of the overall budget (Lasalandra, Boston Herald, 4/11). The group's report also recommended shifting long-term care from nursing homes to community-based and assisted living facilities, "modifying" Medicaid eligibility requirements and instituting copayments for some services (Springfield Union-News, 4/11).
Michigan Lawmakers Propose Changes to Formulary
Michigan legislators have begun considering changes to the state's Medicaid drug formulary, the AP/Detroit News reports (Durbin, AP/Detroit News, 4/13). Under the program, prescription drugs are organized into therapeutic categories, with several best-in-class drugs selected in each category by a small group of state-appointed pharmacists and doctors. Drug companies must reduce their prices to match the lowest best-in-class price in order to have their drugs included in the list of available drugs. Doctors can prescribe drugs not on the formulary but must call a phone bank of pharmacy technicians for approval. The program covers about 1.6 million Medicaid beneficiaries and seniors in state-sponsored programs (Kaiser Daily Health Policy Report, 2/4). The state Senate last month attached to the Michigan Department of Community Health budget for the fiscal year beginning Oct. 1 provisions that would automatically include on the formulary companies that agree to provide discounted drugs to all state programs. The legislation also would lower the discounts drug companies are currently required to provide. The AP/News reports that the proposed department budget is expected to go before the House this week. In addition, state Sen. John Schwarz (R) has introduced a separate bill that would require the state to conduct "regular reviews" of the formulary. The bill would also add patients and drug company representatives to the state committee that chooses the drugs for the formulary (AP/Detroit News, 4/13).
