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MEDICAID
Plan B Available to NY Medicaid Recipients
Beginning February 1, New York Medicaid enrollees ages 18 or older will be able to purchase “emergency contraception” with their Medicaid card and without a doctor’s prescription. The Food and Drug Administration approved over-the-counter sales of Plan B to women 18 and older last summer. The age limit posed a quandary for states Medicaid programs, which in many cases require a doctor’s prescription for the purchase of over-the-counter medications and supplies. The New York Health Department changed its policy in December to allow coverage of Plan B, and will initially provide full reimbursement to pharmacies that dispense the pills. Clients are limited to 6 courses over a 12-month period. The Empire State has now joined Illinois and Washington in covering Plan B.
Risks for Community Pharmacies
Changes in federal rules governing the maximum amount a state can pay under Medicaid for generic drugs may result in underpaying retail pharmacies, according to a study just released by the Government Accountability Office. Each state Medicaid program sets its own reimbursement rates for prescription drugs but a state’s aggregate reimbursements for most generic drugs can not exceed a Federal Upper Limit (FUL). Currently, the FUL for covered drugs is 150 percent of the lowest published price for a drug. In an effort to align the upper limit with prices actually paid for drugs rather than those published, Congress directed that the upper limit be based on an average of prices actually paid by wholesalers for a drug distributed to retailers (AMP). The new upper limit will be phased in between January 1, 2007 and July 1, 2007. Data from the GAO study indicates that the new upper limit—250% of AMP—does not reflect retail pharmacy costs for most of the drugs studied and will result in payments that are on average 36 percent lower than costs for drugs subject to the upper limit. The report notes that pharmacies may mitigate some of these effects if they decide to purchase lower-cost versions of generics or if they can negotiate greater discounts from manufacturers. CMS added in its own analysis that the new FULs would reduce average retail prescription drug revenues by less than one percent.
SUBSTANCE ABUSE
Strawberry-Flavored Meth
Nevada police say they are finding a new kind of methamphetamine on the streets that could appeal to younger users with its strawberry flavor and bright pink color. The Nevada Appeal reported Jan. 29 that the drug has been dubbed "strawberry quick" by dealers and users and is made in Sacramento, California. "Parents and teachers, please be aware of this new kind of drug that is making its way into our culture," said Sgt. Darrin Sloan, commander of the Carson City Sheriff's Department's Special Enforcement Team. Sloan said the flavoring, apparently added during the cooking process, may make snorting the drug more appealing. Young users also may see the colored version as less harmful, although it is just as powerful as regular meth. "This is designed for the younger crowd," Sloan said. "If (dealers) can get younger people using it, they can get long-time buyers." (This story is taken from Join Together, a Robert Wood Johnson Foundation-funded program of the Boston University School of Public Health.)
Study Questions “Gateway Theory” of Drug Use
A new study suggests that a child’s behavioral patterns and neighborhood have as much to do with whether he or she tries marijuana than if the child has tried alcohol or cigarettes first. The study, which appeared in the December American Journal of Psychiatry, questions the “gateway” theory of drug abuse, which alleges that a child will use legal drugs first, then proceed to “soft” drugs like marijuana, and then on to harder drugs such as cocaine and heroin. Instead, the researchers support the “common liability” model, which hypothesizes that behavioral deviancy and genetic risk have the greatest influences on whether an individual will use drugs, legal or non-legal. The study followed 224 boys from ages 10 to 12 until they turned 22. Of those, 99 used legal drugs only (alcohol and tobacco); 97 used legal drugs before they started using marijuana; and 28 used marijuana first before using legal drugs. The researchers concluded that a child’s neighborhood—specifically if it was economically deprived or not—had the biggest effect on whether a child used marijuana. Patterns of delinquency also had a greater impact on marijuana use than prior use of legal substances. As a result, the researchers recommend early intervention for kids with conduct problems, writing “in effect, the greater the deviancy, the more likely an individual is to use an illegal drug. These findings underscore the need to prevent conduct problems in early childhood to diminish the risk of later illicit drug use.”
MEDICAL RESEARCH
Texas Seeks to Become Leading Player
Texas plans to invest $3 billion over the next decade in order to find ways to eradicate cancer. Aiming to become a global leader in cancer research, the effort will combine the research conducted by private companies, state universities, medical schools and the elite University of Texas M.D. Anderson Cancer Center. Two state lawmakers have agreed to sponsor legislation creating the fund, but they have yet to determine how it would be structured and where the money would come from. One option would involve borrowing against bonds to produce $300 million a year for research.
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