Oregon Health Plan formulary proposed

6 March 2001

John Kitzhaber, governor of the US state of Oregon, plans to controldrug costs there by requiring some Oregon Health Plan patients to pay more for drugs not listed in a formulary.

Savings generated by the proposed formulary, which would apply only to the 30% of Oregon Health Plan patients who do not receive services through managed care insurance plans, could cut as much as $7 million from the $885 million which will be spent on medicine for people in the plan for the poor over the next two years, the governor said, adding that the state needed to prioritize what it will pay for.

Patients would have to pay the difference between the formulary-listed drug and one off the list, unless their doctor had granted an exemption because the formulary drug had been tried and failed, or for other health reasons. The formulary would apply to health plan patients who use prescription medications for mental illnesses; these products account for approximately half of the plan's pharmaceutical budget. Managed care plans have their own formularies, it was noted.

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