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Final fee schedule for historic Medi-Cal 2024 rate increases released

May 17, 2016
Area(s) of Interest: Access to Care Advocacy 


The California Medical Association (CMA) announced today that it is supporting a bill (SB 1010, Hernandez) that would require drug companies to provide substantial notice to state programs such as Medi-Cal and CalPERS when drug prices are increased or high-dollar drugs are coming to market. The bill would also require health plans to identify the specific drugs that are driving the most spending among their enrollees. CMA is also exploring other legislative solutions to provide more publicly accessible drug pricing information and protect patients from sudden price increases.


There is currently a crisis of increasing drug costs impacting patient access to needed medicines. In supporting this measure, CMA is calling for a new statewide solution to prescription drug pricing, including greater transparency in prescription drug prices and costs.


“The rising cost of prescription medicines is impacting the ability of California physicians to place patients on the best treatment regimen and provide the very best patient care,” said Steven E. Larson, M.D., MPH, president of CMA. “Improving patient access to needed medicines and increasing transparency around pricing is a top priority for CMA this legislative session.”


At the same time, CMA also announced that it is opposing the prescription drug contracting initiative that is scheduled to be on the November ballot.


“While California’s physicians are profoundly concerned about the affordability of prescription drugs, we evaluated this measure and have concluded it is deeply flawed and unworkable,” said Dr. Larson. “We believe the measure would likely increase – not lower – state prescription drug costs. Of greatest concern to doctors is that the measure would result in a new bureaucratic prior approval process that could interfere with patient access to the medicines they need.”


The ballot measure would prevent certain state agencies from entering into contracts for the purchase of prescription drugs unless the price paid is the same as or lower than the special discounts provided to the U.S. Department of Veteran’s Affairs. The measure could result in the invalidation of existing agreements between the state and pharmaceutical companies that already provide significant discounts to the state.


The cancellation of contracts also would remove many drugs from the Medi-Cal list of pre-approved medicines – creating a new prior authorization hurdle for patients and their physicians.


“CMA supports real reforms to protect consumers and lower drug costs. But this ballot measure is the wrong prescription,” Larson added.


To read the bill, click here.

 

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