Ohio Health Policy Review

1,000 Ohio HIV/AIDS patients lose drug benefits

About 1,000 HIV/AIDS patients who had been eligible for free medication from the state are set to lose their benefits (Source: “More than 1,000 HIV/AIDS patients across Ohio to lose benefits,” Cleveland Plain-Dealer, July 5, 2010).

Ohio’s Ryan White program has seen the number HIV/AIDS patients earning less than 500 percent of the Federal Poverty level receiving free medication increase from 1,962 in 2005 to 4,384 last year. Meanwhile, state and federal funding for the program has remained steady during that time.

Officials with the program say the combination of increased demand from services, which they attribute to increased unemployment, combined with rising drug costs made the cutback necessary.

Ohio House OKs prescription authority for APNs

The Ohio House of Representatives last week passed, by an 85-13 margin, a bill that would allow advanced practice nurses to prescribe Schedule II controlled substances including oxycodone, Ritalin and morphine (Source: “Ohio House gives nurses more prescription drug authority,” MedCity News, May 20, 2010).

Ohio joins more than 30 states that have laws allowing APNs to prescribe medications. Currently, nurse can only prescribe one day’s worth of Schedule II drugs, and only if the medication had previously been prescribed by a doctor.

Strickland Administration creates prescription drug task force

Gov. Ted Strickland signed an excutive order last week to create the Ohio Prescription Drug Task Force, a group charged with developing strategies for addressing illegal prescription drug use (Source: “Ohio Gov. Strickland goes after illegal prescription drug business,” MedCity News, April 2, 2010).

In a press release announcing the task force, the governor’s office said “The task force will include officials from public safety and public health, from medical and pharmacy backgrounds, and from local, state and federal government. It will regularly report its findings and recommendations to the governor and to the leaders of the Ohio General Assembly.”

According to statitics from Sen. Sherrod Brown’s office, unintentional overdose deathes in Ohio increased from 327 in 1999to 1,351 in 2007. In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio.

Strickland said he supports legitimate pain clinics and other legal means that provide addictive medications to patients. He called on the state’s doctors and pharmacists to check the Ohio Automated Rx Reporting System –- a prescription tracking database -- every time they prescribe or dispense pain medications.

Ohio Senate bill would require pharmacy staff to report errors

A bill introduced in the Ohio Senate would criminalize pharmacy staff who do not report errors to the state Board of Pharmacy (Source: “Ohio bill would criminalize non-reporting of serious pharmacy mistakes,” MedCity News, June 3, 2009).

If pharmacists, pharmacy interns or technicians fail to report a mistake within two weeks, they would be charged with a fourth-degree misdemeanor under the proposed law. The bill has been referred to the Senate Health, Human Services and Aging Committee.

“I want this to be a measure for the pharmacy board so they can take remedial corrective action to help avoid serious physical harm or death,” said Sen. Tim Grendell, the bill’s sponsor.

Grendell also sponsored Emily’s Law, a bill passed last year that creates licensing and minimum education standards for pharmacy technicians. The law was named for Emily Jerry, a 2-year-old from Cuyahoga County who died in 2006 because of an error made by a pharmacy technician.

Medical marijuana legislation faces uphill battle in Ohio

Even proponents of a potential bill to legalize marijuana use for medical purposes in Ohio are admitting that its strong opposition will be difficult to overcome (Source: "Medical marijuana a longshot for Ohio,” Toledo Blade, June 1, 2009).

Democratic State Rep. Kenny Yuko of Richmond Heights said he is working on drafting medical marijuana legislation that could be introduced in the fall. Although a recent Ohio Poll conducted by the University of Cincinnati found that 73 percent of Ohioans generally favor the concept, Yuko and other supporters are uncertain about the prospects of passing the legislation.

A bill proposed during the last General Assembly died after a single committee hearing. That bill would have allowed approved patients to keep 7 ounces of marijuana on hand. Proponents have indicated that the new bill likely would reduce the maximum amount of the drug that patients will be allowed to obtain, perhaps more in line with a ballot initiative that was approved in Michigan in November that allows approved patients to have 2.5 ounces.

Among those opposing the legalization of marijuana for medical purposes is the Ohio Prosecuting Attorneys Association. "It's viewed as a controlled substance, and there must be a reason for that," said Association Executive Director John Murphy. "It's regarded as harmful and habit-forming, all the usual reasons. It should remain that way."

Yuko counters that, "People need to keep an open mind about it. We've reached a point in our lives where people can act responsibly with something that has a history of misuse."

Partnership encourages pharmacists to educate consumers about abuse

With drug overdoses now accounting for more accidental deaths in Ohio than auto accidents, the Ohio Pharmacists Association, the Ohio State University College of Pharmacy and Cardinal Health have announced a partnership that aims to enable pharmacists to educate their customers about the misuse of prescription and over-the-counter drugs (Source: “Pharmacists join in abuse fight,” Columbus Dispatch, April 18, 2009).

The partnership came about as an offshoot of the OSU College of Pharmacy’s Generation Rx Initiative, a program the college started two years ago to have students hold informational sessions on campus and in local schools. The partnership plans to focus its educational outreach on abuse among teens. According to the federal Substance Abuse and Mental Health Services Administration, 7 percent of Ohio children ages 12 to 17 misused pain relievers in 2005 and 2006, the two most recent years for which data is available.

"The drug problem is moving from the streets to the medicine cabinet," said Kenneth M. Hale, assistant dean for professional and external affairs at the OSU College of Pharmacy.

Ohio likely to pass tougher pharmacy standards

The Ohio House Health Committee is held hearings this week for a law that would create tougher standards for pharmacy technicians in the state (Source: “'Emily's law' for pharmacy technicians expected to pass,” Cleveland Plain Dealer, Nov. 20, 2008).

Known as “Emily’s Law” in honor of a 2-year-old Mentor girl who died because of a pharmacy technician’s error, the measure would require pharmacy technicians to pass a competency test and criminal background check. The bill passed the state Senate in May.

With backing from the National Association of Pharmacy Technicians and the Ohio Pharmacy Board, the bill is likely to achieve passage during the lame duck session next month.

Report predicts health care costs to increase 10.6% next year

A survey of more than 70 health care insurers conducted by Aon Consulting Worldwide led to a prediction that overall health care costs will increase by 10.6 percent next year (Source: “Report: Health care costs to rise 10.6%,” Dayton Business Journal, Aug. 12, 2008).

Specifically, Aon predicts a 10.6 percent rise for HMOs, 10.5 percent for POS plans, 10.7 percent for PPOs and 10.5 percent for CDH plans. The increases are the lowest since the annual study began in 2001. The researchers who conducted the study attribute the slowing rise in costs to higher employee participation in wellness programs, more health promotion and more consumer-driven programs.

The report also predicts that prescription drug costs will increase 9.2 percent, compared to a 9.5 percent rise last year.

Express Scripts, Incs agrees to $9.5 million settlement with Ohio and 28 other states

The State of Ohio and 28 other states reached a $9.5 million settlement agreement with Express Scripts, Inc.  The agreement relates to the claim that Express Scripts inappropriately encouraged physicians to switch patients to different brand-name medications (Source: "Ohio awarded $410K in Rx benefits settlement," Columbus Business First, May 27, 2008)

Ohio will receive at least $410,000 as a result of this agreement.  This is the second such settlement involving Ohio and a pharmacy benefit manager over drug switching activities this year.  In February, Ohio received funds through a settlement agreement with Caremark Rx LLC.

FTC reports brand name pharamaceutical companies striking deals to delay introduction of generic alternatives

The Federal Trade Commission (FTC) reported that there were 14 cases in federal fiscal year 2007 (October 2006-September 2007) where brand name pharmaceutical companies reached deals with generic drug firms to delay the sale of generic drugs ("U.S. FTC reports 14 deals to delay generics in '07," Reuters, May 23, 2008).  In these deals the FTC found that the generic firms received some form of compensation to delay production.

The FTC did provide the names of the medications affected by these deals.  While the FTC states its opposition to these deals and belief that they violate antitrust law, courts have split on the question of if such deals are legal. 

Ten members of the U.S. Senate are sponsoring legislation to prohibit such deals.  This legislation has found strong opposition from both brand name pharmaceutical companies and makers of generic medications.

FTC Commissioner Jon Leibowitz, commenting on the report, said: "What it shows is that this problem is persistent. It's becoming the new way to do business. It means that consumers in need of affordable drugs are going to get generics later, not sooner."