NC Legislators loosen Medicaid drug limits

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NC Legislators loosen Medicaid drug limits

By LYNN BONNER AND ROB CHRISTENSEN, Staff Writers

In legislative math, the difference between 3 and 5 is $6 million.

A House subcommittee working on the state health budget voted earlier in the month to limit Medicaid recipients to three brand-name prescription drugs per month, with no limit on generic drugs. When a new budget document came out five days later, without any other votes being taken, the number of brand-name prescription drugs per month had been changed to five.

That change erased about $6 million in annual savings for the Medicaid program.

The main beneficiary of the change? The drug companies that sell brand-name prescription medicine.

POLITICAL SCORECARD

UP: JIM BLACK'S STAFF: Working for the House speaker has all sorts of perks. Not only can you get your glasses fixed, but while most state employees are likely to get a modest pay raise, Black's staff is getting raises ranging from 7 percent to 58 percent.

DOWN: DELL: A North Carolina group went to court last week to challenge the constitutionality of a $242 million package of state incentives given to the Texas-based computer company to open a plant in Winston-Salem.

UP: INDUSTRY RECRUITING: North Carolina was named the South's State of the Year by Southern Business & Development magazine. The rankings are based on numerical scores each state receives for recruiting industries that offer a large number of jobs and/or a large amount of private investment.

Legislators are looking to control Medicaid spending by finding ways to reduce drug costs, which take the biggest slice of the insurance program's money. The Senate budget would limit Medicaid patients to eight prescriptions a month without distinguishing between brand-name and generic drugs. It's estimated that would save $2.3 million a year.

Prescription drugs cost the state Medicaid program nearly $1.5 billion this year.

House Speaker Jim Black, a Democrat from Mecklenburg County, said he wanted the limit on brand-name drugs upped to five because some drugs that patients need don't have generic substitutes.

Gary Salamido, a lobbyist for GlaxoSmithKline Inc., said the drug company prefers the Senate version of the drug limit.

More than a dozen states put some kind of monthly limit on Medicaid prescriptions.

But Wanda Moebius, spokeswoman for Pharma, a group representing drug research and manufacturing companies, said some states have found that caps on prescriptions hurt patients. Decisions about prescriptions should be left to doctors, she said.

"People expect physicians to pick the drugs that are right for them, based on their case," she said.