Transcript Document
The Northwest Prescription Drug Consortium An Oregon Perspective by Missy Dolan, Administrator Oregon Prescription Drug Program Political Drama Visionary Leadership Bureaucratic Naiveté (mine) Negotiating Strength Ultimate Success Oregon’s Political Drama 2003: Senate Bill 875 Define Success? 2005: Senate Bill 329 Defeated! 2006: Measure 44 79% of Electorate! Integrating with Part D OPDP enrollment and utilization remained constant post Part D go-live OPDP cards may be used during periods of 100% copay Shoebox solution? Stakeholders insistence! OPDP Launched March 2005 Governor made the announcement at Portland’s Independent Brooklyn Pharmacy 21 months later: $860K in savings 4,600 uninsured members 81% generic usage Funding for OPDP or Like a dog waiting for a bone 2003-2005 appropriations did Not cover the cost of one full Time employee 2005-2007 appropriations did Not cover the cost of two full Time employees Program is bailed out by the Generosity of OOHPR and the State Attorney General Grants Denied First pharmacy benefit contract provided for a reduction in administrative cost of uninsured as critical mass was reached Funding sought for outreach to achieve critical mass & cover uninsured cost Initial eligibility requirements too limiting for funding approval The Opportunity and Cost of Group Enrollment Negotiating Leverage Savings for State Solicitation & Legal Cost Status of Group Enrollment Timing Challenges Jumping into the Pool Legislative Considerations For OPDP in 2007 The Governor Senator Morrisette Speaker Merkeley Visionary Leadership Governor Ted Kulongoski Governor Christine Gregoire Bruce Goldberg, M.D. Interstate Purchasing is Legislatively Intended and Explicitly Authorized ORS 414.312 (3)(g): “[The administrator Shall cooperate with other states or regional Consortia in the bulk purchase of prescription Drugs.” RCW 70.14.060 (1): “The Administrator shall explore joint purchasing opportunities with other states.” Washington Statute the Sky is the limit All Uninsured Public Sector Private Sector An estimated 4.5 million compared to Oregon’s 450K The Will to Create a Partnership Similar Vision Shared negotiation and contracting Shared experience Eventually shared Pharmacy & Therapeutics Include other states The Construction Team Public and Private Statewide and National Economic Impact of Health System Change Brookings Institution PharmD with Mercer background No slackers A Shared Vision Deliver the value that the insured receive to the uninsured. Strategy: A marketable Group product A willing Network A self funded discount program A Willing Network Implications of delivering competitive group rates to the Uninsured WA MedImpact nontransferrable OR Contracting Approach Is a smaller network acceptable? Acceptance = radical shift from business as usual February 1, 2007: Launch Printed materials will promote the network for contracts received by 12/31/06 The Network at Launch Network Strategy At the End of the Day Will Groups be Attracted? Transparency: a Gift for Groups Part of a bigger Pool That Offers Custom NW Care Performance Guarantees Including significant financial penalties for not reaching well defined goals. Group Sales Difficult and Slow (OR only?) Self-insured carveouts RxReins.com Carrier hesitancy Carrier/PBM cooperation with repricing Two-three year contract cycles The Future of the NW Rx Purchasing Pool Considerations Workers Comp-first claim coverage solution? A Foundation for Heinz Report Recommendations? A combined P&T process and Preferred Drug List Attorneys Generals award for Public Awareness Program development New Legislative latitude Montana? Idaho? NEW YORK??!! Your Move! Questions? Contact Information [email protected] 503-373-1595