Florida GenRx Abstract
In 2007, 27 states received Medicaid Transformation Grants under Section 6081 of the Deficit Reduction Act of 2005. The grants were rewarded to states that proposed innovative methods which in the end of the two years are designed to produce better health outcomes at lower cost.
The Center for Health Transformation is highlighting states that have received these Medicaid Transformation Grants, and will be following their progress for the next two years. In order for key decisionmakers and industry leaders from around the country to learn from others’ successes, it is our intention to provide this resource in order to showcase innovative practices from across the nation. In the future, this site will be interactive, allowing program directors to submit updates and comments regarding their program.
Since July 2003 Florida Medicaid has operated a program to support electronic prescribing. Prescribers receive hand-held computers linking them to the Medicaid preferred drug list and patient prescription history. The prescriber can see all drugs the patient has received, check for interactions and compliance, and transmit prescriptions electronically. The proposed GenRx project builds on the success of that program as follows:
- Takes advantage of the upcoming availability of generic products to treat patients using six specific drug classes, particularly those with diabetes or hyperlipidemia;
- Provides the patient with a 10 day starter pack of generic medications during the office visit;
- Electronically transmits the prescription for the generic product to the patient’s pharmacy;
- Provides a base for tracking whether compliance with treatment guidelines improves through closer communication between prescribers and Medicaid pharmacists;
- Increases the use of e-prescribing capability by participating prescribers.
The budget for this project totals $1,737,861, which is $1,202,769 in the first year and $535,092 in the second year. Projected savings through increase of generic use is based on analysis of six drug categories: SSRIs, diabetic medications, cholesterol-lowering agents, third-generation cephalosporins, calcium channel blockers, and alpha-beta blockers. Multiple brand-name drugs in these categories either have been marketed recently or soon will be marketed as generics.
Florida already employs a professional pharmacist in each of its 11 Medicaid service areas. In the first year each Area pharmacist will establish generic medication dispensing in 12 practice sites. Each practice site will have two or more prescribers enrolled in the program who have served at least 200 Medicaid recipients in the past three months. Each participating prescriber will use either a hand-held or office-based computer to do e-prescribing. Each will be enrolled as a dispensing practitioner, and each office will be equipped to print the required drug labeling to accompany the 10-day supply of generic drugs the patient will receive during the office visit.
While the prescriber will have to purchase the supply of generic drugs, the e-prescribing software will automatically process the cost of the prescription through Medicaid and issue payment to the prescriber on a routine basis without further claim submission.
Following the initial year, each Area pharmacist will spend one day each week in two of the practice sites in addition to our current academic detailing program. The purpose is to track the improvement in patient outcomes comparing a focused presence with the current brief visit combined with chart reminders and other leave behind materials. The expected outcomes are broader acceptance of generic drugs by patients, streamlined prescribing, reduction in drug costs to Medicaid, and improved achievement of treatment goals.
