News Release
Governor Martz Announces Plan to Cut Cost of Medicaid Prescription Drugs
7/7/2004
Kris Goss
406-444-3862
kgoss@state.mt.us
HELENA - Governor Judy Martz today announced that Montana is going to join
seven other states in an effort to reduce the cost of prescription drugs
for the state Medicaid program. The multi-state pool is expected to save
Montana taxpayers close to $5 million a year by increasing the buying power of states with small populations.
"This is truly a historic agreement," Governor Martz said. "It is always
encouraging to make government more responsive to the needs of our
citizens. This is an innovative way to rein in the growing cost of prescription drugs for our most vulnerable low-income citizens."
The multi-state pool--which includes Nevada, Michigan, Minnesota, Vermont,
New Hampshire, Alaska, and Hawai'i--is the only one of its kind in the
nation. It represents the first time in the history of the Medicaid program
that states have worked together in such a manner.
"This is a proven, legal and safe way to lower drug costs," Governor Martz
said. "It's an idea whose time has come. Montana and American consumers pay
more than any nation on earth for their prescription drugs. It's important
as a state and as a nation to continue working toward a fair, reasonable
solution to meet the needs of our citizens."
The governor complimented the Montana Department of Public Health and Human
Services for its success in getting Montana accepted into the multi-state
pool. The department expects to implement the plan by the end of this year
under a contract with First Health Clinical Services, one of the nation's
leading pharmacy benefit managers. The plan must be approved by the
Centers for Medicare and Medicaid Services (CMS).
Although not required, every state offers prescription drugs through
Medicaid. However, the rising cost of drugs has strained many state
Medicaid budgets. According to the Montana Department of Health and Human
Services, Montana's Medicaid program spent roughly $95 million on
prescription drugs this fiscal year.
"The pool gives smaller states more clout in negotiating with drug
manufacturers for lower prices," said John Chappuis, Montana's Medicaid
director. "It will ensure that Montana offers Medicaid clients the best
possible medicine at the lowest possible price."
Under the plan, the state will create a list of preferred medications that
have been deemed the most cost-effective by a committee of Montana
physicians and pharmacists. The state Medicaid program will reimburse
pharmacies for prescriptions that Medicaid clients fill for those drugs.
Medicaid clients pay a co-payment of $1 to $5 for each prescription but a
total of no more than $25 a month. Medicaid covers the remaining cost of
the drugs.
The preferred drug list will include medications to cover all classes of
diagnoses. If a physician believes a Medicaid client requires a drug not on
the preferred list, the physician can get prior authorization from the
state Medicaid program to prescribe that drug.
"It is important to note that the plan always takes into account the
patient's well-being," Chappuis stated. "It does not stop a patient and
doctor from choosing any brand of drug if the doctor can demonstrate that
it's medically necessary."
The concept of a multi-state pooling plan has been approved by the U.S.
Centers for Medicaid and Medicare Services and has withstood a court
challenge by pharmaceutical companies in Michigan.
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Kris Goss
Education Policy Advisor and Deputy Communications Director
Office of the Governor
State Capitol
Helena, MT 59620
(406) 444-3862
kgoss@state.mt.us
