Executive Summary
Seeking to further rein in prescription drug spending under the state’s Medicaid program, Florida lawmakers recently enacted new measures to limit rising pre- scription drug spending. Drug manufacturers are required to provide an addi- tional 10 percent price discount on drugs, up to a combined total 25 percent dis- count, or else the drugs would not be included in the state’s newly created pre- ferred list of drugs in the Florida Medicaid program. Florida’s preferred list contains fewer than 830 prescription drugs, making about 1,000 drugs subject to prior authorization.
While mental health drugs are currently exempted from prior authorization requirements, many mental health advocates fear that psychiatric drugs will lose this exemption if cost saving targets for prescription drugs are not met. Florida lawmakers could eventually adopt a “fail-first” policy, requiring schizophrenic patients to “fail” on the older typical antipsychotics before a physician may pre- scribe the newer atypical antipsychotics drug treatments.
The reliance on attempting to control component costs fails to account for the benefits on newer, more effective treatments. For example, the vast preponder- ance of academic literature demonstrates that newer atypical antipsychotics are often far less expensive than the cheaper typical antipsychotics in the long term. The newer treatments have been shown to reduce serious side effects and suffer- ing for patients, as well as to reduce costs for hospitalization and criminal jus- tice.
By attempting to limit access to prescription drug treatments, Florida is allow- ing bureaucrats to interfere and override important health care decisions that rightfully belong with doctors and their patients. Doing so could leave the most vulnerable populations without access to the best available drug treatments. Now is the time for Florida lawmakers to reverse this dangerous course.
