'Time not right' for Medicaid drug list

After pushing for the better part of a year for the establishment of a preferred drug list for Medicaid patients, the director of the Utah Department of Health said Thursday he no longer supports immediate implementation of the list.

"Now is not the time," Dr. David Sundwall told members of the Health and Human Services Appropriations Subcommittee.

A legislative move to shore up support for a PDL — strongly favored in the past by Sundwall and Gov. Jon Huntsman Jr. as a way to save millions of dollars annually to the state's Medicaid program — also will not go forward this year.

Rep. Steve Mascaro, R-West Jordan, who has been a vocal proponent of the measure, said Thursday he will not pursue a resolution that would have affirmed the health department's statutory authority to implement a PDL with or without the approval of the Legislature.

"It's a great idea when the time is right, but it's obviously not right now," Mascaro said.

The change of position represents an about-face for Sundwall, who said in November that he had the governor's blessing to go forward with a PDL even if Mascaro's HJR4 failed.

However, he said Thursday, a new program offering prescription drug coverage through the government's Medicare program has changed the landscape of things.

"The ground has shifted under our feet," he said.

The health department has invested money and continues to use funds to implement Medicare — particularly as it applies to Medicaid beneficiaries — which has made Sundwall's estimate of potential savings under a PDL "a moving target."

"During this session, I'm not confident that I have figures that I can defend," he said.

However, he made clear that he is not abandoning the eventual implementation of a PDL in Utah.

"The PDL remains, I think, a very attractive option for us to manage the Medicaid program prudently and wisely and well and make sure we're getting the best expenditure for our pharmaceuticals," Sundwall said.

Medicaid, the joint state/federal health insurance for the poor and disabled, is the third-largest insurance plan in Utah. Drug coverage is the fastest-growing component of the program's budget, rising by 18 percent in each of the past seven years.

The Executive Appropriation Committee denied a request by the health department to establish a test PDL for two classes of drugs — acid reflux and cholesterol-lowering medications — in July, citing questions about the true cost-saving possibilities of the measure.

The Health and Human Services Interim Committee also declined to support Mascaro's HJ4 in November.

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E-mail: awelling@desnews.com