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Some fear plan to cut Medicaid drug costs

TALLAHASSEE - Kidney transplant recipient Terence Stevens is doing well, thanks to a regimen of antirejection and other prescription drugs paid for by the Medicaid program.

But they're not cheap. And expensive medicines like those taken by Stevens are part of the reason for one of the most vexing problems state policymakers say they face - how to control the rising cost of the Medicaid program.

One of the fixes Gov. Jeb Bush's administration proposes is to try to cut drug costs by only covering the least expensive versions of each medicine.

It's a proposal Bush says would save almost $300-million a year - but it frightens people like Stevens.

Some version of the five kinds of drugs Stevens takes would be available under the proposal, officials say. But they might be different brands, or generics.

Officials say the committee that would approve drugs would consider quality, not just cost.

Many Medicaid recipients aren't so sure. Some say their doctors have tried more than one drug before hitting on a brand that works.

"If my doctor and I are forced to change the prescription from drugs I currently take, my system will be totally destabilized," said Stevens, of Lakeland. "This proposal takes the emphasis away from providing the best prescription for me ... and focuses on finding the lowest cost."

Officials at the Agency for Health Care Administration say the goal is to eliminate the use of expensive medications, but insist it would only happen when there are quality low-cost alternatives, in many cases drugs that could be identical in content to the name brands. "We believe physicians should have choice when prescribing medication," said AHCA spokesman Jonathan Burns. "We also intend for Florida's Medicaid patients to have access to the therapeutics they need."

Bush is pushing for a total revamping of the Medicaid program, which pays health care costs for more than 2-million Floridians. But the drug proposal is seen as way to shave costs in the meantime, starting as early as July. Prescription drugs are the biggest cost in Medicaid, nearly 20 percent of the program's total expenses.

The governor has argued for years that if costs aren't controlled, more draconian cuts might occur.

[Last modified March 4, 2005, 00:30:22]