A panel of pharmacists and physicians appointed by Florida Gov. Jeb Bush has decided it will meet monthly to recommend changes to the state's new and controversial Medicaid drug formulary.
The law authorizing that formulary, which officials call the "preferred drug list," aims to save Florida some $214 million in Medicaid expenses in the next year. Last year, Florida spent roughly $1.5 billion providing prescription drugs to Medicaid patients. Officials hope to prevent that figure from ballooning to $2.5 billion in 2002.
Shortly after Florida enacted its law in July, the trade group representing drug companies filed a lawsuit against the state to protest it. That's because the law requires companies wishing to see their drugs on the preferred list to offer a discount of at least 25% of each drug's average manufacturer price, or other incentives, such as funding community medical programs.
Under Florida's law, physicians prescribing for a Medicaid patient a drug not included on the list must first discuss alternatives with ACS/Consultec, a company contracted by the state Agency for Health Care Administration. Doctors, however, still have "ultimate authority" for which medications they prescribe, said George Kitchens, bureau chief for the Medicaid pharmacy services division of the AHCA.
Some states already have entered the minefield of obtaining pharmaceutical rebates to rein in drug spending, and Florida's law may prompt others with rising Medicaid costs to do the same. Earlier this year, Maine successfully fought a pharmaceutical challenge to its MaineRx program, through which the state negotiates lower prices from drug manufacturers on behalf of residents without prescription-drug coverage.
In Florida, the AHCA compiled a preferred drug list that includes more than 1,300 approved drugs. Earlier this month, Bush appointed a panel of five physicians, five pharmacists and a university professor to review and recommend changes to that list on a regular basis.
"I believe we can develop a preferred drug list that will allow more cost-effective therapy," said Ronald Salem, chairman of the new Medicaid Pharmacy and Therapeutics Committee and general manager at Tampa-based PharMerica, which provides pharmacy services to nursing homes.
The committee Salem chairs met for the first time late last month to consider initial modifications to the list. They will meet monthly for the next few months and quarterly after that, Salem said.
On Aug. 7, the Phar-maceutical Research and Manufacturers of America, which represents the nation's drug companies, filed a lawsuit in U.S. District Court in Tallahassee, Fla., to protest the state's law, saying it violates federal rules governing Medicaid programs. No trial is scheduled.
Reacting to the lawsuit, Bush said, "Protecting the large profit margins for multibillion-dollar pharmaceutical companies is not a priority. We are more concerned about making sure our senior citizens have better access to affordable prescription drugs."