If you controlled your state's public aid formulary

[crossurfingers]

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what would you change? Just curious to see what people think of the drug lists and if anyone has any opinions.

 

[njac]

all birth control options would be on there, not just some.

I had our medicaid for a couple days before I shelled out for school insurance - generic Loestrin wasn't available. That annoyed me to no end.

Ditto for psych meds. Maybe not desvenlefaxine, but any non me-too drugs should be available.

 

[PharmDstudent]

I would restructure the formulary to where it would only allow new medications to be added after P&T-type reviews... which may or may not be the case now. In this state, the formulary is pretty loose. Xyzal finally needs a PA after nearly a year of being dispensed no-prob.

 

[Sparda29]

I'd allow everything to be on there. PAs and Drug Not Covered just makes everyone's life harder.

 

[Charlottefromca]

can someone tell me why Medical only covers brand for so many drugs?

 

[NormalSaline]

no more frickin benzoyl peroxide

 

[Pharmavixen]

No more Oxycontin.

 

[Quiksilver]

every female patient would be on mandatory OC.... **** i don't care about the medications, I would just like to change the stupid laws and regulations on actual prescriptions.

 

[BuffaloPills]

no adhd meds for more than 1 kid in the family, choose wisely

 

[StaviZFingerZ]

can someone tell me why Medical only covers brand for so many drugs?

Most likely large rebate.

 

[PumpkinSmasher]

I'd allow everything to be on there. PAs and Drug Not Covered just makes everyone's life harder.

You are a turd that never shines.

 

[bkiskadd]

No Clomid and mandatory generics.

 

[Sparda29]

You are a turd that never shines.

Maybe there's need to be a better process for initiating PAs. Instead of the MD sending the patient to the pharmacy only to find out the drug is not on the formulary, the MD should check with the state's formulary before prescribing.

There should be no need for the pharmacy to call up the MD office to initiate the PA.

How it should be:
1. Patient goes to MD.
2. MD diagnoses patient.
3. MD checks the formulary to see what drugs are covered for the diagnosis without PA.
4. If they still wanna prescribe something not on the formulary, the MD calls up state Medicaid and does the prior authorization. (This process should not take longer than 5 minutes to complete.)
5. MD writes prescription and gives it to the patient.
6. Patient takes prescription to pharmacy.
6. Pharmacy fills it and is reimbursed.

Right, so if that process is put into place then, this is what I'd do.

1. No more brand name antibiotics, unless they have no generic.
2. All acne medication covered.
3. All OC is covered.
4. All vaccines covered.