PhRMA Statement on Proposed Changes to Medicaid in Louisiana

WASHINGTON, Sept. 12, 2012 /PRNewswire-USNewswire/ -- Pharmaceutical Research and Manufacturers of America (PhRMA) Senior Vice President Matthew Bennett issued the following statement today on proposed changes to Medicaid in Louisiana:

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"Seeking new approaches to coordinate care for Medicaid and LaCHIP recipients is critically important. However, without proper protections for patients, the Louisiana Department of Health and Hospitals' (DHH) plans could put vulnerable Medicaid patients at risk. New laws passed by the Louisiana legislature and signed by Governor Bobby Jindal in 2011 and 2012 protect patients by providing a balance between the need to address increasing budget considerations and ensuring patient safety. DHH's proposal indicates that those patient protections, which were designed to curb overzealous rationing of care under prior authorization and step therapy schemes, may be in jeopardy. PhRMA is concerned that it may leave final prescriptive authority with insurance companies rather than physicians.

"The aim of integrating benefits should be to increase patient adherence to prescribed medicines. Greater adherence to prescription regimens improves the quality of health outcomes and reduces medical costs.

"In addition to maintaining the patient safety protections approved by the legislature in 2011 and 2012, rules promulgated by DHH should include access to a range of prescription medicines, including, where available, a minimum of two brand-name treatments; guaranteed access to successful therapies at least until the time a physician is able to find another equally beneficial medication; and a transparent review system for all formulary management tools. However, it should be noted that the DHH plans are moving very rapidly, which raises additional concerns about having adequate time to ensure patients will receive needed protections and quality of care is upheld.

"It is important that any plan to coordinate care for Medicaid patients not inadvertently stint on patients' access to needed treatments. Not only do such policies harm patient health, but they can run counterproductive to lowering medical expenses. For example, Harvard research found that limits on the number of Medicaid prescriptions reimbursed for chronically ill elderly and disabled people resulted in a 35 percent reduction in the use of clinically essential medicines and a 200 percent increase in the use of medical services such as skilled nursing facility and emergency mental health services, exceeding the cost of medicines.

"Limiting the number of medicines a patient can receive is the wrong approach. Not every patient responds to every medicine in the same way, making it vitally important for physicians and patients to have a choice among multiple therapies when deciding on the best treatment plan.

"We look forward to working with Secretary Greenstein and the Louisiana DHH to ensure that state Medicaid patients receive the high quality health care coverage they deserve."

The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country's leading pharmaceutical research and biotechnology companies, which are devoted to inventing medicines that allow patients to live longer, healthier, and more productive lives. PhRMA companies are leading the way in the search for new cures. PhRMA members alone invested an estimated $49.5 billion in 2011 in discovering and developing new medicines.

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SOURCE Pharmaceutical Research and Manufacturers of America