Company Seeking Legislative Change in Oklahoma on Transplant Drugs

By Jeff Packham

A bill attempting to require physician and patient approval for any changes in immunosuppressive drug prescriptions is being pushed by a pharmaceutical company with Oklahoma ties.

Jim Turner, associate director for Astellas Pharma U.S., encouraged the Oklahoma Legislature during a public hearing Friday to do what was best for the patient when it came to changes made to transplant medications instead of holding back due to cost concerns. Astellas Pharma is a Deerfield, Ill., company with a manufacturing plant in Norman.

In speaking before the Senate Appropriations Subcommittee on Health and Social Services, Turner said any changes to the medication schedule of a transplant recipient at any time after the surgical procedure could have significantly negative effects on that person.

Turner warned that if a patient switched from a brand-name immunosuppressive drug prescription to a generic without consulting his physician, it could cause problems almost immediately. He said besides the potential of the patient mixing up medications, one change in medication could cause a change in blood levels and affect other medications being taken by the patient.

A transplant patient takes anywhere from 10 to 25 different pills daily, Turner said.

Oklahoma Health Care Authority officials said their role in the process had more to do with making sure that the appropriate level of funding was attached to this legislative request.

Nico Gomez of OHCA said the result of this legislative proposal – which is being proposed as part of House Bill 1373 – would be for OHCA to exempt the drug from the SoonerCare pharmacy benefit, which covers up to six prescriptions per month and up to three brand-name drugs per month.

Gomez said by removing this drug from that list, it would allow the participants to add another drug to be covered instead. He said this would definitely cause the agency to have additional costs by having to cover the costs of what would be a seventh drug.

“It’s going to run against the (prescription) limit,” Gomez said.

That cost was originally expected to be nearly $300,000 in state revenues, but Gomez admitted that this was the cost of the immunosuppressive drugs. He said when considering the average of other drugs that would replace those drugs on the list, the cost came down to $114,000 in state revenues.

If the bill were to pass, those drugs would be added to a list of other prescriptions exempt from the pharmacy benefit. Those include chemotherapy for cancer, drugs to treat HIV/AIDS, oral contraceptives, and hemophilia blood factor products.

Nancy Nesser, pharmacy director for OHCA, said the reasons for exempting these drugs were all legitimate and had been in place for several years. One example was the chemotherapy medication, which she said was required four times a month and would actually exceed the three brand-name drugs covered if a brand name were used.

“Therapeutically, there are good reasons for these to be exempt,” Nesser said.

As for the coverage for the immunosuppressant drugs, the agency already has a policy in place that includes no restrictions, no limitations, and no prior authorization required. Dr. Lynn Mitchell, the state’s Medicaid director, said in the end, the agency already did what it could to ensure the patients were doing what was best for themselves when it came to their medications.

“We certainly don’t put our members in those positions,” Mitchell said in response to concerns about the effect of a change in medication.

The bill sits in the Senate subcommittee now with a possibility of a hearing during the upcoming session. State Sen. Constance Johnson, D-Oklahoma City, said it was important that the groups got together to talk about the costs and see what needed to be done as far as the next step.

Originally published by Jeff Packham.

(c) 2007 Journal Record – Oklahoma City. Provided by ProQuest Information and Learning. All rights Reserved.