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Saving state money and improving health quality with a preferred drug list

Joining the many states that already use a preferred drug list – an evidence-based list of which drugs are most effective and cost the least – has always been a stretch for the pharmaceutical-friendly General Assembly. It’s hard to see your way clear to saving millions in taxpayer dollars when those millions will come from a friendly and extremely wealthy industry in your state. No state health program uses a preferred drug list – it’s actually specifically prohibited.

Commentators have been calling for just this sort of change in North Carolina for years but political pressure has always blocked reform. Now budget realities are actually making a preferred list a possibility.

The News and Observer tomorrow will examine this issue in more depth (if the Easley mess doesn’t drive it off the front page), and that’s a good thing. We can save money in health care – we’ve put multiple suggestions out there – and this is one great way to do it.

One worry that often comes up with a preferred list is that some people may be doing very well on a particular drug and changing that drug could have adverse consequences, especially for people on mental health medications. One way to deal with this – simply grandfather in all the people currently taking mental health drugs. Start the preferred list with new prescriptions. This might take a little longer to save money, but would be less disruptive.

A final safety would be for doctors to be able to affirmatively act and override the list if they really believed a patient needed a particular drug despite all the research. We have to be careful with this – some of the most prominent child psychiatrists in the country have recently been involved in scandals where they took millions from the pharmaceutical industry and promised they would conduct research studies where the outcome would enhance the “commercial goals” of a particular drug company.

Saving money while improving quality in health care is certainly possible with a preferred drug list. It just takes political will.

One Comment


  1. Leadership Conference

    June 9, 2009 at 2:18 pm

    a lot of people have absolutelty no confendence that the General Assembly is capable of solving the health care mess. The solutions are federal.

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