1863 Medical Assistance program; preferred drug list  

  • DEPARTMENT OF
    PUBLIC WELFARE

    Medical Assistance Program; Preferred Drug List

    [35 Pa.B. 5586]

       The Department of Public Welfare (Department) will begin a phased-in implementation of a Preferred Drug List (PDL) on October 1, 2005. Drugs within therapeutic classes included in the PDL that do not appear on the PDL will require prior authorization on and after that date, as authorized by section 443.6(b)(7) of the Public Welfare Code (62 P. S. § 443.6(b)(7)).

       The PDL is a clinically based list of covered outpatient drugs, referred to as ''preferred drugs.'' Preferred drugs are those drugs that are determined to be the best in a particular therapeutic class of drugs, based on clinical effectiveness, safety and outcomes. Other drugs in the therapeutic class, identified as ''nonpreferred drugs,'' will remain available but require prior authorization.

       All classes of drugs covered under the Medical Assistance Program will be included on the PDL, and each drug within the class will be designated as ''preferred'' or ''nonpreferred,'' with the exception of drugs classified as HIV/AIDS drugs. All drugs classified as HIV/AIDS drugs will be included on the PDL as preferred drugs.

       The Department will phase in implementation of the PDL and will notify all prescribers and pharmacies of each class of drug as the class is included on the PDL, the preferred drugs within the class and the effective date of implementation by publication of a Medical Assistance Bulletin.

       As new drugs become available in the marketplace, they will be designated as nonpreferred and the Department will require prior authorization for prescriptions for those drugs.

    Fiscal Impact

       These changes are estimated to result in savings totaling $99.152 million ($45.602 million in State funds) in the Medical Assistance Outpatient Program in Fiscal Year (FY) 2005-2006. Savings are estimated $109.961 million ($50.613 million in State funds) in FY 2006-2007.

    ESTELLE B. RICHMAN,   
    Secretary

       Fiscal Note: 14-NOT-442. No fiscal impact; (8) recommends adoption. Implementation of this notice will generate savings to the General Fund beginning in FY 2005-2006 of $45.60 million. Savings for FY 2006-2007 are estimated at $50.61 million.

    [Pa.B. Doc. No. 05-1863. Filed for public inspection October 7, 2005, 9:00 a.m.]

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