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
Iowa General Assembly
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