Nearly every group, that is, except lobbyists for pharmaceutical companies. So, we have to assume that their comments - and the thousands of dollars contributed to legislative campaigns - carried greater weight than the evidence presented by doctors, pharmacists and advocates for the state's disabled, elderly and poor.
The decision of the Joint Executive Appropriations Committee is insupportable and Gov. Jon Huntsman Jr. should exercise his authority to adopt the list without legislative approval.
The effectiveness of a PDL in cutting costs of the underfunded Medicaid program are well-documented in research done by the Utah Department of Health and by the experience of other states that have limited Medicaid reimbursement to drugs on a preferred list. State Health Director David Sundwall estimates that the adoption of a pilot list including only two drug classes would save the state $5 million on an investment of $150,000.
Some mental health advocates fear the list would make it difficult for their patients to receive the specific psychotropic drugs they need. A provision that allows any doctor to override the PDL by phoning for approval of a particular medicine appears to address those fears. Sundwall has promised there would be no bureaucratic obstacles for doctors who feel a particular drug is needed.
Most Utahns who are covered by private insurance plans are quite accustomed to using a PDL. Like the one proposed for Utah Medicaid patients, many private plans use lists of the least-expensive drugs available that have been shown to be safe and effective.
The Legislature rejected a PDL in 2003, and this time Senate President John Valentine sounded ready to close off all future debate: "I'm not convinced more information will allow us to make a better decision."
With the legislative leadership covering its ears to all but the drug companies, Huntsman should take a leadership role and adopt the PDL in the interests of the state and its Medicaid recipients.
