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Governor Perdue implements preferred drug list in NC Medicaid

Post on March 15, 2010 by 6 Comments »

Last year, the pharmaceutical industry won yet another round in the NC General Assembly when they successfully fought off yet another attempt to implement a comprehensive preferred drug list in NC. Commentators been writing about such a list for years and it’s pretty simple – almost every state and private health insurance plan does this already. The state develops a list of drugs that are the most effective and steers people towards using those drugs. Drugs that aren’t effective or even dangerous will be discouraged or even not paid for unless individual physicians make specific requests for patients. The list discourages very expensive drugs that research shows work no better or are even less effective than drugs that are much cheaper. For patients it means better care and for the state it means less taxpayer money spent on drugs – everyone wins.

Governor Perdue acted where the legislature didn’t or wouldn’t on this issue. Legislation last year allowed the possibility of a preferred drug list if enough savings didn’t come from the half measures the General Assembly instituted at the behest of the pharmaceutical industry. Well, savings weren’t realized, the state is in a budget hole, and it’s finally time to act on this commonsense reform. Patient care will be primary – the state has a group of committed physicians that will advise on the formulation and use of the list – and overall we can expect patient care to improve while costs go down.

This is the kind of smart health reform we need to see more of and good for the Governor for putting it into practice.

Possibly related posts:

  1. Everyone knew NC Medicaid would be cut drastically: What I said on June 2, 2011
  2. In the next two months the federal “Super Committee” could wreck NC’s Medicaid program and cost our state millions of dollars.

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Comments (Closed):6

  1. Elaine Mejia
    March 15, 2010 at 10:20 pm

    This is great news! One silver lining to deep budget holes is that spending cuts that make sense can get some attention and action. There are a few more of these areas that should be explored – certain economic development programs that have not created jobs and smart sentencing reforms that would save on prison costs and not make us less safe.

  2. Dragan Glas
    March 16, 2010 at 7:57 am

    Greetings,

    Agreed.

    Watching the Health Reform issue from “across the pond”, I find it hard to understand why the legislature voted against the public health interests of NC citizens in the first place!?

    If I were governor, I’d have them explain themselves to the public – particularly their constituents.

    Kindest regards,

    James

  3. Adam Searing
    March 16, 2010 at 10:07 am

    At this point I wish I was across the pond as well!

  4. Alex
    March 16, 2010 at 11:40 am

    Just as long as everyone realizes almost all generics in the U.S. are made by one company Teva. Why is that important? Teva is first of all not a U.S. company. It can pretty much break U.S. drug companies patents with paying fines. It does not get sued when a drug goes wrong the name brand does? It has drug companies all over the world and the generics can be manufacture anywhere. Teva plans to double its profits in five years.

  5. Dragan Glas
    March 16, 2010 at 2:24 pm

    Greetings,

    @Adam, frustrating, isn’t it!?

    On a related note…

    For all the talk of America being a “capitalist” economy, you don’t have any real competition in the health sector – unlike the UK, for example.

    In the US, the health insurance companies have neatly washed their hands of the elderly – let the public take care of the cost through Medicare – whilst being able to “make a killing” off those least likely to be sick. Those who do fall sick, the insurers wash their hands again by tearing up their policies – if they don’t choose to go “medically-bankrupt” first.

    In the UK, for example, the public health option (the UK’s National Health Service) and the private health insurance companies compete against each other.

    When I worked there, I was automatically covered by the NHS (despite being Irish, as I was a taxpayer) whilst I was also a (voluntary) member of my private-sector employer’s health plan (£480 per year – that’s right, only £40 per month).

    Pre-existing conditions? Irrelevant!

    If I needed medical treatment – operation, etc, – I could choose whether I wanted it on the NHS or the company’s private policy (quicker – though not necessarily better, as the same doctor might be treating you; just privately).

    You might say that the NHS kept the private insurance costs down – to some extent, that’s true.

    However, there’s more to it than that…

    The CBI – the organisation which represents the UK’s private sector, including the insurers – ensures that the insurance companies don’t fleece the non-insurance companies (which are, after all, the vast majority of the private sector).

    Why? Because it’s bad for business.

    At the moment, in NC – not to mention the US – with regard to the relationship between the insurers and the rest of the private sector, it’s not just a case of the tail wagging the dog; it’s a case of the tail sucking the life-blood out of the dog. Eventually, the dog will collapse from loss of blood – the private sector (and the economy) will die.

    Which only emphasises my point: in the absence of a public option, it’s imperative that the private sector sit the insurers down and say, “We won’t allow you to fleece us!”.

    Why doesn’t the US Chamber of Commerce – or NC’s affiliate – do the same as the CBI??

    They could act as a mediator for the non-insurance sector of the US/NC private sector and negotiate (enforce!) economically-viable premiums for the non-insurance businesses. (No need for an “Exchange”.)

    Unbelievable failure of the US private sector to follow the first rule of business: keep an eye on your costs!

    *Sorry – rant over.*

    Kindest regards,

    James

  6. Dragan Glas
    March 16, 2010 at 2:28 pm

    Greetings,

    @Alex, makes you wonder why the US pharmaceutical companies don’t set up a single generic drug company and manufacture their own – they could then sell these to the US at competitive prices to Teva’s.

    It’d be a win-win situation for them: profits either from generics or new drugs.

    Another failure of the US private sector!

    Kindest regards,

    James