Medicaid Clients May See Changes in Some Drug Prescriptions
January 26, 2005
Here is where the content goes.Some of Montana's 83,000 Medicaid recipients may see changes in the drugs they are prescribed as the state begins implementation this month of a new "preferred drug list" program.
The program will officially begin in March, according to Duane Preshinger, head of the Acute Services Bureau of the Montana Department of Public Health and Human Services (DPHHS). But the department has recommended that health-care providers begin transitioning their patients to the preferred drugs now.
Last year, Montana joined a multi-state pool with the goal of reducing the cost of prescription drugs for the state Medicaid program. The pool-which includes Nevada, Michigan, Minnesota, Vermont, New Hampshire, Alaska, and Hawaii-is the only one of its kind in the nation.
"The pool gives smaller states more clout in negotiating with drug manufacturers for lower prices," Preshinger said. "It will allow us to offer Medicaid clients the best possible medicine at the lowest possible price."
The program is expected to save Montana taxpayers close to $5 million a year, he noted. Montana's Medicaid program spent about $95 million on prescription drugs in fiscal year 2004.
DPHHS laid the groundwork for the preferred-drug program last summer with the creation of a committee of physicians and pharmacists charged with reviewing therapeutic classes of drugs. The committee identified those classes in which the state can save money without sacrificing quality of care and developed a list of preferred medications in each class.
"It's important to stress that this plan does not stop a patient and doctor from choosing any brand of drug if the doctor can demonstrate that it's medically necessary," Preshinger said. "A doctor can get prior authorization from the department if they want to prescribe a drug that's not on the preferred list, and Medicaid will cover that prescription just as it does preferred drugs."
The department began sending notices to prescribers this month, alerting them to situations where Medicaid clients are taking drugs not on the preferred list. Pharmacists are being asked to contact physicians and urge them to review their patients' medications.
"Physicians should begin to prescribe the preferred medications when writing new prescriptions for Medicaid patients," Preshinger said. "We also encourage them to get prior authorization where necessary before the program begins in March."
Page last updated: 06/15/2006
