The EBRx Process
- Providing High Quality Care
- Controlling Costs to Avoid Cuts in Services or Reimbursements
- Avoid Care Delivery Hassles
Those are the goals for most healthcare providers. They are also the driving forces guiding development of the Arkansas Medicaid Preferred Drug List (PDL). The Evidence-based Prescription Drug Program (EBRx) was created to ensure that Arkansas’ Medicaid PDL provides access to medications which provide clinical advantages and the opportunity to control costs.
Over the past eight years, Arkansas Medicaid prescription spending has grown at an average annual rate of 16 percent. Unfortunately, average prescription costs continue to rise.
As the state’s budget is finite, the current prescription cost growth is unsustainable. The challenge facing EBRx is ensuring access to medications proven most effective and safe while providing cost control.
EBRx uses a two committee approach to develop the PDL:
- Drug Review Committee
- Drug Utilization & Cost Committee
Drug Review Committee
EBRx maintains a Drug Review Committee (DRC) composed of Arkansas physicians and pharmacists. These professionals evaluate safety data, as well as evidence of relevant clinical difference between similar drugs. The DRC receives public input and carefully deliberates on comprehensive scientific reviews, often times performed by the Oregon Evidence-based Practice Center (EPC). Each month, the DRC makes recommendations in a new drug class.
The committee may find that all or several agents are equally proven and without significant clinical difference, or that only a single agent should be selected for a specific condition. Products not proven to be as safe or effective as other agents are excluded from further consideration, and cannot become preferred drugs.
Drug Utilization & Cost Committee
When possible, EBRx recommends drugs to the PDL which present an opportunity to reduce costs, such as many generic drugs. Drug use and cost data for the Medicaid program are reviewed by a committee of Arkansas physicians and pharmacists. Pharmaceutical manufacturers are encouraged to provide competitive discounts to lower the cost of medicines to the Arkansas Medicaid Program. Sometimes, the reduction in cost provided by the pharmaceutical manufacturers is very significant and can lead to surprising choices for the PDL.
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