Court Backs Prescription Drug Curbs

Michigan acted legally when it attempted to cut costs by limiting the drugs doctors can prescribe to low-income patients, the state appeals court said in a decision released Monday.

The unanimous decision was a victory for the Michigan Department of Community Health. It also sent a clear signal to other states, which have been waiting to see if courts would approve Michigan’s unique approach.

“This allows us to continue to offer high-quality health care to low-income Michigan citizens and prudently manage costs,” Community Health Director James Haveman said Monday.

Drug companies and mental health advocates, who sued to stop the plan, said they were disappointed with the decision.

“Patients in Michigan are being denied the medicines their doctors want them to have,” said Bruce Lott, a spokesman for the Washington-based trade group Pharmaceutical Research and Manufacturers of America, or PhRMA.

Michigan’s plan, which went into effect in February, requires doctors to use a state-developed list when prescribing medications to patients who rely on state aid, including Medicaid fee-for-service patients and programs for infants and the elderly. The program will eventually cover around 1.6 million patients.

Doctors must get state authorization for medications not on the list, which was developed by a committee of physicians and pharmacists selected by Republican Gov. John Engler.

Some drugs were allowed on the list because they were considered medically necessary. In other cases, drug companies were told to give discounts or risk being left off the list.

PhRMA and mental health advocates said the state program endangers patients’ lives and is unconstitutional because it was never considered by the full Legislature.