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Drug bill makes more generics accessible

Proponents say it will save money. Other bills that passed muster affect nursing home staffing and Medicaid.


© St. Petersburg Times, published May 6, 2001

Proponents say it will save money. Other bills that passed muster affect nursing home staffing and Medicaid.

TALLAHASSEE -- Cheaper drugs, more nursing home staff and plugging a $1-billion shortfall in Medicaid topped lawmakers' health care priorities for 2001.

Months of intense and expensive lobbying added four drugs to those for which pharmacists can automatically substitute generic equivalents. Doctors still can write "medically necessary" on the prescription to require the brand-name drug.

The list of affected drugs includes the popular brand-name blood thinner Coumadin.

Proponents of the bill say it will save money for thousands of Floridians, many of them elderly and on fixed incomes. But opponents said Coumadin in particular is very "dose-sensitive" and automatically switching to a generic drug could harm patients.

"It is disappointing that the (Legislature) has not listened to the experts on this issue," said Byron Thames, chairman of the Florida Coalition for Patient Safety, a group backed by brand-name drugmaker DuPont that was fighting the bill. Thames said his organization plans to appeal to Gov. Jeb Bush to veto the bill. After the bill passed the Senate on Wednesday, a Bush spokeswoman said the governor has not taken a position on the issue.

Lawmakers also dramatically increased staffing requirements for the state's nursing homes and limited the lawsuit judgments that can be awarded against them. Nursing home operators complain that lawsuits are driving up their insurance premiums, while trial attorneys say they wouldn't sue if the homes delivered quality care.

This year was the third in a row that lawmakers tried to pass a bill, and it was one of Bush's declared priorities.

"The governor did an incredible amount of lobbying," said Lt. Gov. Frank Brogan after the House adjourned late Friday night. The combination of higher staffing levels and lawsuit limits could have a noticeable effect on the insurance market in as little as six months, Brogan predicted.

"Will this bring them back? The answer is yes." The nursing home bill passed well after lawmakers solved another headache that crept up on them this year: a nearly $1-billion shortfall in the state Medicaid budget. Signing up poor kids for state health insurance and underestimating how many people would need the programs led to the shortfall.

Lawmakers shaved several hundred million dollars from Medicaid expenses, making some cuts to programs, to plug the hole.

But a bill to reopen the state's high-risk insurance pool for very sick people failed to pass.

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