The current draft requires that the Secretary of Human services establish an independent office, the office of prescription drug cost control within Agency of Human Services. The office will include the Drug Utilization Review Board, the pharmacy and therapeutics advisory committee and any other board with functions relating to best practices in the use of prescription drugs. It will develop a utilization review program, uniform statewide formulary, standards for utilization, and a uniform script for the state sponsored Medicaid programs and any public or private health benefit plan that agrees to participate. The office may create an electronic database to promote cost effective use of prescription drugs. The office is required to provide information education to physicians, medical students and other prescribers on therapeutic and cost effective use of prescription drugs.
Authority falls to the pharmacist to select the equivalent lowest price drug on the formulary.
If a drug is prescribed that is not on the formulary, the patient will have to pay the difference in price. As currently drafted, the bill includes expansion of the Federally Qualified Health Centers and restores the cut in Medicaid reimbursements to pharmacists made by the administration last year. It also includes aid to those who experience catastrophic prescription drug costs based on costs in relation to income. The committee believes savings will be realized as a result of using the formulary and anticipates these savings could fund this program. However, it has included language to limit the program to available appropriations.