News
Using a Clinical and Evidence-Based Strategy to Preserve Access to Psychiatric Medications
January 1, 2004
Pharmacy costs have skyrocketed over the past decade hitting growth rates in the double digits. Medicaid and other public assistance programs have been no exception. Medicaid agencies throughout the country are grappling with ways to manage pharmacy costs while maintaining access to needed medications for their enrollees/members. States are trying multiple methods to manage costs such as Preferred Drug Lists, Supplemental Rebates, increased co-payments, decreased dispensing fees to pharmacists.
While managing general medical drugs is difficult, managing drugs used to treat psychiatric diseases is exceptionally difficult. In the last legislative session NH has opted out of managing these classes of drugs altogether, yet, this carve out is now in legislation to be changed.
Some states approached the management of pharmacy costs from a clinical perspective first, using cost as a basis for management only when other things (clinical effectiveness, safety profile) were equal as determined by clinical experts. This method of evaluation and management was used for psychiatric drugs also, and has been very successful.
In managing the pharmacy, there are no easy solutions, but solutions that are clinically based and include all stakeholders have a better chance of being successful than other less measured approaches or approaches that are solely based on cost.
The article, "Using a Clinical and Evidence-Based Strategy to Preserve Access to Psychiatric Medications, by Ken Duckworth, M.D., and Annette Hanson, M.D., MBA, demonstrates the approach taken in Massachusetts.
