June 24th, 2009

Announces a press release from the Pharmaceutical Research and Manufacturers of America:

For the sake of patients and state taxpayers, Pennsylvania should continue to avoid carving drug coverage out of the Medicaid managed care program. Separating medicines from the rest of health care to be managed by the government disrupts the ability of managed care organizations to use pharmaceutical treatments as a way to help control disease and reduce overall health costs. Many prescription medications – when used in combination with healthy diet and exercise – help to prevent patients from developing full-blown disease and expensive, debilitating surgeries and hospitalizations are avoided.

Medicines are cost-effective and account for only 10 cents of each health care dollar. They should remain part of an integrated managed care system that emphasizes quality patient care. With a government-managed drug benefit, poor Medicaid patients who depend on the state for treatment could fall victim to officials who are not health professionals and whose predominant focus is program cost-cutting.

The availability of a wide range of medication options can be particularly important in the fight against chronic diseases, including heart disease, cancer and diabetes. Governor Rendell last year said chronic medical conditions are “the leading cause of death and disability in Pennsylvania and account for 80 percent of our health care costs.”

The taxpayer benefits from maintaining the state’s current Medicaid system because with managed care, health plans receive a fixed amount per patient and then assume responsibility for covering unexpected cost increases. In contrast, state government-run fee-for-service programs assume all of the risk of unexpected expenses and taxpayer money is used to cover the costs.

In the end, a Medicaid drug carve-out in Pennsylvania could hurt both the state’s most vulnerable patients and taxpayers and that hardly seems like a wise prescription.