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Pfizer offers Florida Medicaid a deal backed by cash
Pfizer and Florida have cut an unusual deal aimed at saving them both money. Other states and drug manufacturers are closely watching the deal for signs of success or failure. Florida has agreed to place 23 of Pfizer's drugs on the new Medicaid formulary without requiring supplemental rebates that other manufacturers must offer to make the preferred list. Nonformulary drugs need prior authorization.
In exchange, Pfizer pledged to hire 60 specially trained nurses based in 10 hospitals to manage care for certain beneficiaries with asthma, congestive heart failure, diabetes, and hypertension. The company also said it would provide free prescription drugs, worth $3.9 million, to an estimated 50,000 beneficiaries who receive care from 30 community health centers and would also launch a health literacy effort.
But the key to the public-private pact is the cash guarantee. Pfizer asserted that the package, especially the pilot disease state management project, would save the state $33 million over two years. If it doesn't, Pfizer will fork over the difference.
"How come pharmacists are not included in this" is the typical reaction from members of the Florida Pharmacy Association (FPA), executive director Michael Jackson told Drug Topics. "We've advocated for years that if you want to control healthcare costs overall and if you want to improve the quality of health, you need to utilize the services of a pharmacist."
FPA is working with the Agency for Health Care Administration, the state Medicaid administrator, to establish a network of 50 to 100 R.Ph.s skilled in managing Rx therapy to provide pharmacy-based care. Jackson doesn't know how or if this will fit into Pfizer's disease state management arrangements with the same agency. "This will involve intensive monitoring and managing a patient's drug therapy with the goal of improving compliance, improving health, lowering costs, and getting better outcomes," he said.
Mike Conlan. Pfizer offers Fla. Medicaid a deal backed by cash.