Drug Discount Plans Draw Criticism
Some advocacy groups for people with mental illnesses and low-income people oppose proposals by Gov. Arnold Schwarzenegger (R) and Democratic legislators to create a prescription drug discount program, the San Francisco Chronicle reports.
Legislation (AB 2911 and SB 1702) by Assembly Speaker Fabian Nuñez (D-Los Angeles) and Senate President Pro Tempore Don Perata (D-Oakland) would require pharmaceutical firms to reduce prices to a level set by the state for California residents who are ineligible for Medi-Cal, California's Medicaid program (Lucas, San Francisco Chronicle, 8/22).
State residents would be eligible for the program if they do not have state-sponsored prescription drug coverage and their household incomes do not exceed 350% of the federal poverty level. The program also would be open to Medicare beneficiaries in some circumstances and to California residents whose household incomes do not exceed the state median and whose out-of-pocket drug costs exceed 10% of their annual income (SB 1702 text, 5/18).
If drug makers do not reduce prices to the state level within three years, the state would require physicians to obtain prior approval before other medications manufactured by the company could be prescribed to Medi-Cal beneficiaries.
According to the Chronicle, the governor's proposal would have a lower eligibility limit and would allow more time for drug makers to reduce prices. The Schwarzenegger proposal has been released to legislators only in draft form.
Advocates for low-income people say quality of care will be compromised under the plans by requiring additional steps to prescribe some treatments to Medi-Cal beneficiaries.
Mental health advocacy groups have voiced concerns that requiring prior approval before some treatments can be prescribed could encourage doctors to prescribe older, less effective treatments to Medi-Cal beneficiaries with mental illnesses.
Schwarzenegger, Nuñez and Perata say that their plans include provisions to maintain access to treatments for Medi-Cal beneficiaries with chronic conditions if the manufacturer's treatments are removed from the state formulary (San Francisco Chronicle, 8/22).