Bill would expand preferred drug list

The Health and Human Services Committee heard testimony Feb. 4 on a bill that would expand the Nebraska Medicaid Preferred Drug List.

LB466, introduced by Grand Island Sen. Mike Gloor on behalf of the governor, would add antidepressants, antipsychotic and anticonvulsant therapeutic drug classes to the list, which was established by the Legislature in 2008.

Gloor said the list currently contains 64 classes of drugs and a committee, in conjunction with the state Department of Health and Human Services, determines the best and most cost-effective medications on the market for inclusion.

The three classes included in LB466 were not included in the original legislation, Gloor said, but the state’s current fiscal situation has led to a reconsideration of that decision. The bill would save Nebraska just under $2 million over the next two fiscal years, he said.

“Adding these [classes] would provide appropriate pharmaceutical care to Medicaid recipients in a cost effective manner,” he said, adding that current Medicaid patients would be grandfathered in and could remain on their current drug regimens. In addition, he said, exemptions could be provided for new patients if a medical reason is given for using a non-preferred medication.

Kerry Winterer, chief executive officer of HHS, testified in support of the bill, calling its passage “essential” to the governor’s budget.

“These classes consist of mostly brand name drug products,” he said, meaning that the savings from including antidepressants, antipsychotics and anticonvulsants would be greater than for other classes of drugs.

Linda Jensen of the Nebraska Nurses Association testified in opposition to the bill, saying the biochemical variations between different antipsychotic drugs can greatly impact their effect on patients.

“Finding the most helpful medication and dosage can take a lot of trial and error,” she said. “People can recover, they can get better and have productive lives, but they have to have the right meds.”

Dr. Cheryl Buda, an Omaha psychiatrist, also testified in opposition, saying the bill could increase psychotic episodes, incarcerations and hospitalizations as patients are transitioned between drugs in order to comply with a preferred drug list.

“Switching meds is probably the number one factor that leads my patients to hospitalizations,” Buda said.

The committee took no immediate action on the bill.