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Cutting Down on Health-Care Costs

FRIDAY, Jan. 14 (HealthDayNews) -- Requiring enrollees to get permission before filling prescriptions for proton pump inhibitor (PPI) anti-ulcer drugs enabled the Georgia Medicaid program to cut its prescription drug costs by $20.6 million in a year, says a study in latest issue of the American Journal of Managed Care.

PPIs are brand name drugs used to treat acute upper gastrointestinal conditions such as ulcers and esophagitis.

A budget review revealed that PPIs accounted for 5.6 percent of Georgia Medicaid''s pharmacy costs and ranked first in costs among all classes of prescription drugs. The review found that some program enrollees were receiving PPIs for a number of conditions that didn''t warrant PPI use.

It was noted that lower-cost generic histamine type-2 antagonists (H2As) were possible alternatives for these patients.

In February 2002, Georgia Medicaid put in place new rules that required enrollees to get approval before they filled prescriptions for PPIs. The new rules increased the use of generics from 31 percent to 79 percent.

PPI expenditures decreased from $44.1 million to $13.2 million, and H2A expenditures increased from $6 million to $13.5 million. There was a net savings of $20.6 million for the year.

The study, conducted by pharmacy benefit management company Express Scripts, said that requiring prior authorization for PPIs did not result in any adverse health consequences for enrollees.

More information

The American Academy of Family Physicians has more about ulcers.



-- Robert Preidt



SOURCE: Express Scripts, news release, Jan. 14, 2005

Last Updated: Jan-14-2005
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