A state committee Wednesday approved a list of cancer drugs that a physicians’ group says could limit how doctors treat Medicaid patients.
“I just want to know why some drugs are on the list and some are not,” said Dr. John M. Rainey, of Mamou, a board member with the Louisiana Oncology Society.
Some members of the Medicaid Pharmaceutical and Therapeutics Committee, which oversees the medications purchased by taxpayers for patients who receive health care through Medicaid, said that despite the list, all the drugs would still be available. The 21-member committee accepted the recommendations of a contractor to add 10 of 14 cancer medications that can be taken orally to the “Preferred Drug List,” commonly referred to as the PDL.
Rainey said endorsing any list of medications limits the drug options available to a physician.
Similar drugs can have differing impacts on different people, Rainey said. Making one drug more difficult to prescribe – because it is not on the PDL – could allow one cancer victim to survive while another might not, Rainey said.
“All cancer patients, including those in the Medicaid program, deserve complete and timely access to the medications necessary to treat their illnesses,” Andrew Muhl, government relations director with the American Cancer Society, said in a prepared statement. “Any barriers to accessing cancer drugs could mean the difference between life and death for someone battling the disease.”
Dr. Larry Hebert, of Baton Rouge and chairman of the pharmaceutical committee, said physicians are not precluded from prescribing the drugs not included on the PDL.
Generally, Hebert said, physicians need only write a prescription for medicine included on the PDL and the government will pay for the treatment. If the drug is not on the list, then the physician must first seek approval to prescribe it, he said.
“The bottom line is that Medicaid patients have access to all drugs, just like everybody else,” Hebert said. “They just have to take that extra step.”
Cancer drugs are very expensive – costing between $3,000 and $7,000 a month – and government, whose tax dollars are paying the costs, should have a say in their use, Hebert said.
Additionally, having a PDL allows Medicaid to take advantage of “rebates” offered by the private drug companies to include their products on the list, he said.
“That amounts to a lot, lot money,” said Hebert.
Medicaid is a joint state and federal program that helps pay for the health care of people who cannot afford to buy insurance on their own. About 1.2 million of the state’s 4.5 million residents are enrolled in Medicaid, mostly low income, children and the elderly.
After approving the cancer drugs for the PDL, the pharmaceutical committee then voted to ask a state Department of Health and Hospitals panel to study the drugs — who is prescribing them, when and why — then make recommendations when Hebert’s committee revisits the issue in the spring 2012.