Text: H01634 Text: H01636 Text: H01600 - H01699 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Amend House File 715 as follows: 1 2 #1. Page 15, by striking lines 21 and 22 and 1 3 inserting the following: 1 4 "1. a. The department shall continue prospective 1 5 drug utilization review and may establish drug 1 6 surveillance prior authorization under the medical 1 7 assistance program. 1 8 b. The department shall develop and implement an 1 9 individual patient tracking system to assess the 1 10 effectiveness of the drug prior authorization program. 1 11 The system shall include patient specific elements 1 12 including, at a minimum, the drug prescribed or 1 13 requested, the alternative drug dispensed, the 1 14 quantity requested, the quantity dispensed, and the 1 15 drugs dispensed during required trials. 1 16 c. The department shall conduct a prior 1 17 authorization cost-effectiveness study, at no cost to 1 18 the state, and shall not use any entity or individual 1 19 currently or previously utilized by the department to 1 20 perform the study. 1 21 d. The prospective drug utilization review and 1 22 prior authorization cost-effectiveness studies shall 1 23 include, but are not limited to, all of the following: 1 24 (1) The net cost of the substitution of brand name 1 25 drugs for which alternatives are required, including 1 26 the drug rebates, if applicable, under the Iowa prior 1 27 authorization regimen. 1 28 (2) The costs attributable to the ambulatory 1 29 treatment of iatrogenic, unexpected conditions which 1 30 result when the prescribed drug is not authorized and 1 31 a substitution is made under the Iowa prior 1 32 authorization regimen, when it is possible to 1 33 determine that the conditions resulted from the 1 34 substitution of the alternative medication for the 1 35 prescribed medication. 1 36 (3) The costs attributable to institutionalization 1 37 and treatment for iatrogenic, unexpected conditions 1 38 which result when the prescribed drug is not 1 39 authorized and a substitution is made under the Iowa 1 40 prior authorization regimen when it is possible to 1 41 determine that the condition resulted from the 1 42 substitution of the alternative medication for the 1 43 prescribed medication. 1 44 (4) The costs of prescribing mandates, such as 1 45 requiring two failures of generic drug treatment 1 46 before allowing the prescribing of a brand name 1 47 alternative. 1 48 (5) The measurement of the cost-effectiveness of 1 49 patient outcomes under prior authorization compared to 1 50 the patient outcomes under prospective drug 2 1 utilization review. 2 2 (6) The comparison of administrative costs for 2 3 prior authorization review and prospective drug 2 4 utilization review. 2 5 The department shall review the methodology for 2 6 calculating and projecting costs savings and shall 2 7 update the methodology, if necessary. 2 8 The costs identified under the studies performed 2 9 shall be netted against the cost savings projected by 2 10 the department to accurately determine and report cost 2 11 savings for the drug prior authorization program. 2 12 The department shall submit a report of the studies 2 13 to the general assembly on or before March 1, 1998, 2 14 for review. Subsequent to that date, the general 2 15 assembly may direct the department to remove from the 2 16 categories of prescription drugs for which prior 2 17 authorization is currently required, all of the drugs 2 18 for which the comparative studies establish that 2 19 prospective drug utilization review is at least as 2 20 cost-effective in patient outcomes as prior 2 21 authorization." 2 22 2 23 2 24 2 25 HANSEN of Pottawattamie 2 26 2 27 2 28 2 29 HOUSER of Pottawattamie 2 30 2 31 2 32 2 33 BLODGETT of Cerro Gordo 2 34 HF 715.512 77 2 35 pf/jw/28
Text: H01634 Text: H01636 Text: H01600 - H01699 Text: H Index Bills and Amendments: General Index Bill History: General Index
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