Striking more deals with drug companies, joining forces with the health plan for teachers and state employees, and hiring a managed care company to handle prescription drug benefits were among the options for reducing the state Medicaid program's drug costs that a legislative task force explored Wednesday.
The Health Reform Legislative Task Force is examining Medicaid spending on drugs, as well as medical services, as it crafts recommendations for improving the program.
Among the changes the task force is expected to recommend is a replacement program for the state's private option, which uses federal Medicaid funds to buy private insurance for more than 218,000 low-income Arkansans.
Under the private option, private insurance companies administer enrollees' drug benefits and their medical coverage in exchange for monthly premiums paid by the state Medicaid program.
Although the panel focused Wednesday on drug spending under the traditional, fee-for-service Medicaid program, lawmakers will ultimately study whether the private option is the most efficient way to provide prescription drugs, as well as other benefits, said state Sen. Jim Hendren, R-Sulphur Springs and a chairman of the task force.
Jason Derden, administrator of Arkansas' Medicaid drug program, said the state spent about $326 million on prescription drugs in the fiscal year that ended June 30, 2014, but received about $160 million in rebates from manufacturers.
The state receives rebates in exchange for including drugs on the Medicaid program's preferred drug list.
Rory Rickert, a senior consultant with The Stephen Group of Manchester, N.H., told lawmakers that Arkansas' list is narrower than that of other states.
Arkansas' list includes only drugs in classes where evidence shows some drugs are more effective than others. In some classes, such evidence doesn't exist, even though the drugs differ in price, he said.
"You're going to miss classes" of drugs, Rickert said.
He said Arkansas could also increase the size of the rebates it receives by joining a purchasing pool with other states.
Dwight Davis, director of the Evidence-Based Prescription Drug Program at the University of Arkansas for Medical Sciences College of Pharmacy, said Arkansas should also consider establishing a single formulary, or list of covered drugs, that would be used by the Medicaid program in addition to health plans covering teachers and state employees.
That would "send the same message" to pharmacists about which drugs are covered.
"With all the drug plans that are out there, it's so confusing," Davis said. "No one can keep up with it."
Metro on 07/16/2015