Drug Bills Get Cost Warnings

Apr 9, 2014

Despite criticism that it would cost the state Medicaid program too much, a bill that would let doctors break plan rules on prescribing passed its final Senate committee on Tuesday, The Florida Current reports.

The bill (SB 1354) would allow doctors to override “Step Therapy” -- derided as “Fail-First Therapy” -- when it is in the best interest of patients, despite the rules of Medicaid plans. In Step Therapy, doctors are instructed to try the least expensive drug for the diagnosis first, and if that fails, can try more expensive drugs.  

A representative for the Florida Insurance Council and Florida Blue said the proposal would raise Medicaid costs because some doctors will prescribe name-brand drugs rather than generics when it’s not necessary, according to the Current.

Another bill involving prescription drugs (SB 1014), which would impose regulations on pharmacy benefits managers, would cost the State Employee’s Group Insurance Trust Fund $34 million over the  next five years, according to a report described in a separate article from The Florida Current.  

The proposal, which has been approved by three Senate committees, requires the drug benefit managers to change their formula for pricing generic drugs.