The idea of a preferred drug list, which would encourage use of generic drugs and require approval for others, was declared dead last month by legislative budget leaders. Miffed by the lack of debate, West Jordan Republican Rep. Steve Mascaro said he will sponsor a resolution encouraging the state Health Department to go ahead and run a limited test of such a list.

The resolution may also require health officials to report back to the Legislature on results of the pilot project before making it broader.

"This is a program that has the potential to lower Medicaid costs. It's a policy decision that deserves attention and debate from the full body of the Legislature," he said.

Mascaro believes Health Department Director David Sundwall could adopt a drug list without legislative approval, but would risk the wrath of lawmakers who hold the purse strings.

Citing data from some of the 26 other states that have restricted Medicaid reimbursement to a predetermined list of medicines, Sundwall pitched the drug list as capable of saving $5 million from Utah's $1.5 billion Medicaid budget.

That estimate was based on limiting the program to two drug classes - acid reflux and cholesterol-lowering medicines. Sundwall had originally proposed a comprehensive list, but scaled back to the pilot test.

Under intense lobbying by the pharmaceutical industry, Utah lawmakers have soundly rejected a drug list twice in two years.

Medicaid director Michael Deily says Mascaro came up with the resolution without prodding by health officials.

"If the Legislature passes the resolution, to me, that would reflect the will of the Legislature, and we would certainly follow that. There will be some legislators who disagree, but we would proceed," said Deily.

"He [Sundwall] has a very keen interest in this. It's definitely a priority."

Senate President John Valentine welcomes further debate, but believes the Executive Appropriation Committee's bipartisan rejection of the drug list on July 19 "reflects the will of the body."

Acknowledging it was a close vote, the Orem Republican said Maine's preferred drug list has been shown in studies to have caused patient care to suffer, by forcing doctors to jump through red tape to get certain medicines.

"I'm not closing the door on further discussion. But if we're going to do this, we're going to do this in a way that's not hurting people," Valentine said.

House Speaker Greg Curtis still objects to a drug list, arguing "I don't believe the savings the department represents are there. . . . They come to meetings and throw out big numbers, but we just want it explained better."

kstewart@sltrib.com