State Auditor’s Report Finds Costs of Rx Drugs for Inmates, Mentally Ill Have ‘Skyrocketed’ in Last Five Years

Prescription drug costs for "thousands" of California inmates and the mentally ill have "skyrocketed" in the past five years "as the state's outmoded prison pharmacy system teeters near collapse," according to a state auditor's report. The San Francisco Chronicle reports that between 1996 and 2001, the cost of prescription drugs for inmates, the disabled and others in California increased about 34% each year -- three times the national rate -- to $135 million per year. Although state officials acknowledged "serious flaws in the system," they said that the "most often" prescribed drugs, new HIV and mental health treatments, represent "some of the most expensive" on the market. In addition, they said that the demand for antipsychotics and antidepressants among inmates has increased by 34% since 1999, "in part because of a lawsuit requiring California to revamp how it treats mentally ill inmates." However, the 78-page report found that the Department of Corrections has "no way of effectively tracking questionable prescriptions given to inmates" or to identify prison doctors who write "too many high-cost prescriptions." The report "did not come as a shock" to Department of Corrections officials, who have hired a private consultant to evaluate the agency's drug purchasing and tracking systems, programs they say are "in danger of imminent failure."

The report also includes "harsh words" for the Department of General Services, which negotiates most drug purchasing contracts for the state. The report found that the department "failed to negotiate enough contracts below the wholesale price" and "jumped too quickly" into a drug purchasing pool with Massachusetts "without checking other buying cooperatives." Department of General Services officials said that the agreement with Massachusetts could save the state $3 million, adding that the agency "remains open to joining forces with other states." In addition, the Chronicle reports that although the state has "lagged in signing contracts, it has low-cost agreements for the most-prescribed drugs, again saving the state" (Salladay, San Francisco Chronicle, 1/15).