May 4th, 2008

With the increased interest by the DPW to institute a pharmacy benefit carve out from the managed care organizations; more attention has been placed on the Department’s Pharmacy and Therapeutic Committee (P&T) which determines the drugs placed on the state’s PDL. If the carve out occurs, almost all of Pennsylvania’s Medical Assistance patients will be subjected to the state PDL. (The assumption is that DPW will bid the Southwest Region in 2009).

This attention has highlighted some concerns about the current P&T process and how drugs are approved for the PDL. For instance, the committee is currently comprised of 25 members, the majority of whom are Department employees, public comment is very limited, a large portion of the meetings are held behind closed doors, and there is no process for appeals.

A letter signed by seventeen patient advocacy groups from across the Commonwealth outlined the necessary modifications to the current P&T Committee process. These changes addressed the membership issues, public comment limitations, meeting notices/minutes and the need for an appeals process. DPW Secretary, Estelle Richman, along with several legislators received this letter in advance of their February 26 meeting as a formalized request for these changes.
However, the proposed changes to the committee by-laws, have not yet been released in written form or placed on the website, and therefore are not finalized. As a way to codify these changes, Senators Jay Costa and Rob Wonderling have introduced legislation, SB 1337. This legislation will address the concerns of the current P&T committee and ensure a more transparent process.