Nexium removed from Medicaid list
MONTPELIER — The acid reflux-fighting drug Nexium has been taken off the state's preferred drug list for Medicaid patients as officials seek to slow the rapid rise in costs for prescription drugs.
The heavily advertised "purple pill," made by AstraZeneca, will not be available to patients under the publicly funded health care system unless their doctors certify that no other drug is effective with the individual patient.
The move comes as the state tries to save money in a health program that is projected to have a $42 million deficit as of July 1, 2007, and as drug costs have moved to the forefront of the trend toward higher health care expenditures.
"It's not unique to Vermont. It's not unique to Medicaid," said Ann Rugg, deputy director of the Office of Vermont Health Access, which administers the Medicaid program. Drug costs "are number one for any insurance program."
Prescription drugs cost the state $191.4 million in the 12 months ending last June 30. That was up 24 percent from the previous year and was three times more than the cost for Medicaid patients' inpatient hospitalizations.
"Using chemicals for treatment is a tool for saving costs in other areas and it has a huge impact on quality of life," Rugg said.
But brand-name drugs often are significantly more expensive than generic versions. And in the case of Nexium, the Drug Utilization Review Board, a group of 12 doctors and pharmacists that studies the use of medicines, determined that "there are adequate clinically appropriate alternatives available at lesser cost," Rugg said.
Medicaid patients can have pharmacists automatically fill prescriptions for medications on the preferred drug list. For a drug not on the list, the pharmacist has to ask the doctor to get approval from the state's prescription drug manager.
Saludos Cordiales
Dr. José Manuel Ferrer Guerra
The heavily advertised "purple pill," made by AstraZeneca, will not be available to patients under the publicly funded health care system unless their doctors certify that no other drug is effective with the individual patient.
The move comes as the state tries to save money in a health program that is projected to have a $42 million deficit as of July 1, 2007, and as drug costs have moved to the forefront of the trend toward higher health care expenditures.
"It's not unique to Vermont. It's not unique to Medicaid," said Ann Rugg, deputy director of the Office of Vermont Health Access, which administers the Medicaid program. Drug costs "are number one for any insurance program."
Prescription drugs cost the state $191.4 million in the 12 months ending last June 30. That was up 24 percent from the previous year and was three times more than the cost for Medicaid patients' inpatient hospitalizations.
"Using chemicals for treatment is a tool for saving costs in other areas and it has a huge impact on quality of life," Rugg said.
But brand-name drugs often are significantly more expensive than generic versions. And in the case of Nexium, the Drug Utilization Review Board, a group of 12 doctors and pharmacists that studies the use of medicines, determined that "there are adequate clinically appropriate alternatives available at lesser cost," Rugg said.
Medicaid patients can have pharmacists automatically fill prescriptions for medications on the preferred drug list. For a drug not on the list, the pharmacist has to ask the doctor to get approval from the state's prescription drug manager.
Saludos Cordiales
Dr. José Manuel Ferrer Guerra
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5:41 PM
