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PhRMA sues Florida over Medicaid formulary

The state says it needs to save money or patients won't have good access to drugs; physicians say nonphysicians shouldn't decide what makes the list.

By Tanya Albert, amednews staff. Sept. 3, 2001.

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Another state program aimed at reducing prescription drug costs is under fire, this time in Florida.

The Pharmaceutical Research and Manufacturers of America in August filed a lawsuit in a Tallahassee federal court to try to stop the state's new Medicaid drug program. The group challenged similar laws in Maine and Vermont, and those cases are winding through the courts.

Under Florida's law, which took effect July 1, pharmaceutical companies must offer a rebate on their drugs to have them included on a state formulary. If the drug is not on the list, doctors must get prior authorization to prescribe it to Medicaid patients.

Physicians say they understand the state's need to try to reduce skyrocketing drug costs. But, they say, adding another layer of bureaucracy to Medicaid could make it harder for them to do their jobs and ultimately could have a negative effect on patient care.

"Doctors are anxious to do something about costs," said Florida Medical Assn. President Terence McCoy, MD. "We have to live within means. But it does pose increased problems when someone other than a physician is deciding what is on a formulary."

A patient might be switched to a drug that is on the formulary, but that medication might not be as effective as the original one, he said. Also, changing drugs can be confusing for a patient and ultimately could send that person to the emergency department if they didn't follow instructions properly, Dr. McCoy said.

"I'm not opposed to the idea of a formulary," he said. "It's how it comes about." [...]