Michigan Department of Community Health Releases Update to Preferred Drug List
June 27, 2003
Michigan Department of Community Health Director Janet Olszewski today announced that the Michigan Pharmacy and Therapeutics Committee has completed its annual clinical review of the Michigan Pharmaceutical Product List. The list, also referred to as the Preferred Drug List, applies to persons with Medicaid insurance coverage or in other department-sponsored coverage programs.
"While the Michigan Pharmacy and Therapeutics Committee reviews new drugs as they come onto the market, they also conduct a thorough clinical review on an annual basis to evaluate any changes that should be made to the Michigan Pharmaceutical Product List," said Olszewski. "This annual clinical review is crucial as we move forward to achieve additional savings through the use of the nation's first multi-state purchasing pool for pharmaceuticals."
Michigan, Vermont and South Carolina have announced plans to implement the nation's first multi-state purchasing arrangement for pharmaceuticals paid for under their respective Medicaid and other federally approved programs. Under the multi-state initiative, each state must have a preferred drug list in place in order to participate.
"By increasing our purchasing power we can save additional taxpayer dollars while providing high quality pharmaceuticals to our beneficiaries," said State Medicaid Director Paul Reinhart. "We have had serious discussions with many states who are interested in Michigan's approach to reigning in the costs of prescription drugs and expect to see more states join our multi-state partnership."
"States are facing very difficult choices due to the economic climate and getting better prices for pharmaceuticals is one of many ways we are trying to reign in costs in the Medicaid program," said Olszewski. "We feel getting lower prices on prescription drugs is a better option than limiting the number of prescriptions a person can receive a month, cutting Medicaid provider payments or dropping people from Medicaid."
The physicians and pharmacists serving on the Michigan Pharmacy and Therapeutics Committee carefully review scientific and clinical information concerning the drugs that account for the majority of the increased drug spending in the Medicaid program and recommend multiple drugs in each class as preferred drugs. As a result of this careful clinical review, drugs designated as preferred drugs are not necessarily the least expensive in their class.
The Michigan Department of Community Health continues to work with physicians, pharmacists and beneficiaries on the use of the Michigan Pharmaceutical Product List. The process for prior authorization is not unique to Medicaid beneficiaries and is commonly used by physicians and pharmacists for nearly all insured individuals.
If the prescribed drug requires prior authorization, the prescribing physician's office is asked by a pharmacy benefits technician a set of questions, approved by the Michigan Pharmacy and Therapeutics Committee. If the answers to these questions meet the established criteria, prior authorization is granted immediately. If not, it can be further pursued through a prompt, straightforward process to determine the drug's medical necessity.
The Department of Community Health spends over $1 billion annually providing pharmaceuticals for 1.4 million Medicaid and non-Medicaid beneficiaries. The Michigan Pharmacy and Therapeutics Committee follows a clinically based process when reviewing and evaluating the Michigan Pharmaceutical Product List. The list ensures that all Medicaid beneficiaries receive the same comprehensive pharmacy coverage available, while reducing the cost of pharmaceutical products to the state. Physicians and patients continue to have access to all FDA approved drugs.
Last week, Olszewski announced that the Michigan Pharmacy and Therapeutics Committee had made changes to the Michigan Pharmaceutical Product List to make more mental health drugs available without the need for prior authorization.
"We continue to be responsive to the needs of persons in the mental health community and recognize the delicate balance of mental health treatment," said Olszewski. "Making more of these critical drugs available without the need for prior-authorization helps to avoid possible setbacks in care due to changes in drug treatment therapy."
The Michigan Pharmaceutical Product List can be found on the Michigan Department of Community Health website at www.michigan.gov/mdch and by clicking on "Providers" and then "Information for Medicaid Providers" and then on "Michigan Pharmaceutical Best Practices." The changes to the list will be phased in starting July 1, 2003.