Posts Tagged ‘MassHealth’

Cost-cutting measures should not be at the expense of patient care – Dr. Dorkin

Posted in Health Policy, Medicare, Medicine on April 2nd, 2018 by MMS Communications – Comments Off on Cost-cutting measures should not be at the expense of patient care – Dr. Dorkin

It’s no secret that health care in the United States – including here in the Commonwealth – is expensive, and the rising cost of prescription drugs plays no small role in that.

However, as physicians who are dedicated to the health and wellbeing of our patients, we cannot prioritize cost-cutting measures over the ability of our patients to get the treatment they need.

I understand firsthand the importance of treatment options when it comes to the children for whom I provide care. Quite simply, some medicines work better for certain patients. When it comes to asthma or cystic fibrosis – conditions that I treat – the difference between medicines can mean life or death.

I also know that new medications can make life-changing differences in the health of my patients. Once the U.S. Food and Drug Administration has completed its thorough review of a new drug – after years and years of research and development – it is imperative that I be able to introduce that medicine to appropriate patients, rather than waiting for an additional state-level review.

I raise these points because of my concern – as a physician and as the president of the MMS – with the proposed MassHealth closed drug formulary.

Our Massachusetts health program, admittedly, takes up a large share of the state budget. At the same time, the benefit to our community is significant, and it is why the Commonwealth is viewed as a trailblazer when it comes to health care delivery innovation.

All of our patients matter. Those who are covered by MassHealth – adults and the disabled who get their care through Medicaid and children who are insured under the Children’s Health Insurance Program – deserve just as much access to care as any other patient.

A closed drug formulary will limit the ability of physicians to give their patients the care they need. While a proposed exception process has been created, this will only lead to additional delays in treatment for patients and administrative burdens for doctors. Again, this is not in the interest of improved patient health, but rather in reduced health care costs; that’s why we urge MassHealth to accept physician input in creating this process.

In light of a renewed dialogue about the MassHealth closed drug formulary proposal, I urge MMS members to revisit our submitted comments, and share your thoughts on the impact of such a formulary, if implemented, in the comments to this post.

Again – the Medical Society recognizes the difficulties in balancing MassHealth’s mission to provide comprehensive care to roughly two million residents with the very real budget limitations that the program faces. We simply want to ensure that the tough decisions this balance requires do not interfere with quality care for the patients of the Commonwealth.

Henry L. Dorkin, M.D, FAAP, President, Massachusetts Medical Society