Gov. David Paterson inherited a $4.4 billion budget deficit. To close part of it, state Assembly members put public health on the chopping block when they passed the budget last month. Of course, they promised that their legislation would ensure that "quality, affordable health care is available for all New Yorkers." But it will have the opposite effect.
One of the budget's more damaging provisions restricts the medicines doctors can prescribe by applying the "Preferred Drug List" — medications physicians are allowed to prescribe to Medicaid recipients — to the more than 500,000 New Yorkers enrolled in Family Health Plus, a state-run health care program for low-income families. The list consists mainly of older, cheaper alternatives to cutting-edge medicines.
Considering that prescription drugs represent only 4.9 percent of the state's Medicaid budget, it's a penny-wise, pound-foolish proposition.
Drugs not on the list aren't covered unless the patient's doctor gets "prior authorization" from the state. This involves a phone call from the doctor to a government office; a process that severely slows down treatment and deters doctors from prescribing unapproved drugs.
This policy isn't anything new. Some drugs have always required over-the-phone approval by
The results of this reform could be worse than anyone realizes. One survey by Project Patient Care and Harris Interactive found that in 2001 alone, drug restrictions caused 1.1 million Americans to experience negative health outcomes and 1.9 million to experience serious side effects because they couldn't get the meds they needed.
The irony is that this cost-saving plan won't even work. Numerous studies have shown that instituting a rigid list of approved medicines doesn't save any money. This seems obvious — if a patient is denied the appropriate drug, he'll end up visiting the hospital and emergency room more often.
The new budget also hits pharmaceutical companies for the right to treat poor patients. In order to get a drug approved and onto the Preferred Drug List, pharmaceutical companies have to pay a large "rebate" to the state. Drugs that aren't heavily discounted by the manufacturer are often left off the approved list.
Fleecing drug companies in this way isn't only unfair, it threatens public health by siphoning money from research and development on tomorrow's cures. In the long run, this lowers the quality of health care for everybody, not just low-income New Yorkers.
