Some Attempts by Idaho To Reign in Prescription Drug Costs Under Medicaid Stalled

Several of Idaho's attempts to trim $70 million from its spending on Medicaid this year have fallen through, two weeks into the new fiscal year, the Spokane Spokesman-Review reports. Prescription drug costs represent the fastest-rising part of Idaho's Medicaid expenses and could surpass hospital and nursing home expenses as the largest part of the budget this year. To curb costs, the state considered limiting Medicaid beneficiaries to four prescriptions per month, a move expected to have saved the state $26.8 million over the next year. However, that plan has "been scrapped" temporarily because the state's computer system took as long as 30 minutes to pull up an individual beneficiary's drug history and check for "conflicts, duplicates and other problems." As a result, Idaho Health and Welfare Department officials have ordered a "sophisticated new software system" that will make it easier to review beneficiaries' prescriptions. The new system is expected to arrive in September, and department officials say it will save the state "more than $5 million this year just in efficiencies." But Ross Mason, spokesperson for the Health and Welfare Department, said, "There is no intent at this point of starting that program up. It would probably be next year sometime if we restart it, and frankly, that would be probably optimistic."

Moving Forward
The health department still is "pushing ahead with other changes to try to make up some of the lost savings," the Spokesman-Review reports. For instance, the state plans to save $10.5 million by mandating prior authorization for Medicaid beneficiaries to fill prescriptions for nonsedating antihistamines, acid-reflux drugs, arthritis remedies, anti-nausea drugs, name-brand prenatal vitamins and an ointment used by diabetics. The Health and Welfare Department is "at least trying to raise the awareness of the physicians not to give in to the patients coming in and wanting the drugs they saw on TV," Dr. Robert Lehman, a physician who sees Medicaid patients, said, adding, "You can't justify Vioxx for most people when it's no stronger than two Advil." However, Bill Foxcoft, executive director of the Idaho Primary Care Association, said, "I don't think the consumer should be the one that the burden is put on. It seems to me that in many cases, they need those things right away" (Russell, Spokane Spokesman-Review, 7/14).