By CHRIS YAGELO
Capital News Service
LANSING — Health care may be easier to come by for low-income patients thanks to a new program being activated by the Department of Community Health.
The Michigan Court of Appeals this week lifted an order that kept the department from implementing the Michigan Pharmaceutical Best Practices Initiative.
The Ingham County Circuit Court had issued the order based on a complaint by the Pharmaceutical Research Manufacturers Association (PHARMA).
“We are extremely pleased to move forward with our efforts to offer high quality health care to low-income Michigan citizens while prudently managing costs,” said DCH Director James K. Haveman Jr.
Implementing the initiative will save almost $42 million for state health agency, according to departmental estimates.
“If we were not able to move forward with this initiative, it could have had a devastating impact on beneficiaries, since we would then be forced to cut $42 million from health-care services,” Haveman said.
The initiative offers doctors more options for prescribing medicines to low-income patients.
If a patient needed a drug that required prior authorization, that drug would be used. However, if a less costly drug can be used, doctors would have the option of prescribing that drug instead.
“If a drug is medically necessary, that’s the drug the patient would get,” said Geralyn Lasher, director of communications for the DCH.
Doctors would be able to provide patients less expensive drugs if the drugs were found to be safe by the Michigan Pharmacy and Therapeutic Committee, a panel of 11 doctors and pharmacists appointed by Gov. John Engler in October.
“The most important factor to this initiative is that doctors will not be limited to what drugs they can prescribe,” Haveman said.
An estimated 1.6 million people would be affected by this initiative, including the almost 350,000 who are a part of the Medicaid fee-for-service program. Pharmaceutical expenses for that program alone have doubled since 1999.
The department spends almost $1 billion per year on pharmaceutical fees for Medicaid and other health care programs.
The initiative saves money through supplemental rebates offered by the drug manufacturers.
If the Michigan Pharmacy and Therapeutic Committee found a drug that was more effective than the prior authorization drug, but more expensive, the DCH asked the manufacturer for a rebate to bring the price down.
PHARMA originally brought suit against the DCH under the claim that the plan was unconstitutional.
According to PHARMA, the only group that could require an additional rebate from the drug manufacturers would be the Legislature.
The trade association also claimed that there was not a clear separation between the executive and legislative branches of government.
© 2002, Capital News Service, Michigan State University School of Journalism
By CHRIS YAGELO