39-7,121a. State medicaid preferred drug formulary; advisory committee; evaluation of drugs and drug classes; rebates; discounts and services; review of formulary.
39-7,121a
39-7,121a. State medicaid preferred drug formulary;advisory committee; evaluation of drugs and drug classes; rebates; discountsand services; review of formulary.(a) The Kansas health policy authority may establishan advisory committee pursuant to K.S.A. 75-5313, and amendments thereto, toadvise the Kansas health policy authority in the development of a preferredformulary listing of covered drugs by the state medicaid program.
(b) The Kansas health policy authority shallevaluate drugs and drug classes forinclusion in the state medicaid preferred drug formulary based on safety,effectiveness and clinicaloutcomes of such treatments. In addition, the Kansas health policyauthority shall evaluatedrugs and drug classes to determine whether inclusion of such drugs or drugclasses in astarter doseprogram would be clinically efficacious and cost effective.If the factors of safety, effectiveness andclinical outcomes among drugs being considered in the same class indicate notherapeutic advantage,then the Kansas health policyauthority shallconsider the costeffectiveness and the neteconomic impact of such drugs in making recommendations for inclusion in thestate medicaidpreferred drug formulary. Drugs which do not have a significant, clinicallymeaningful therapeuticadvantage in terms of safety, effectiveness or clinical outcomes over otherdrugs in the same classwhich have been selected for the preferred drug formularymay be excluded from the preferred drugformulary and may be subject to prior authorization in accordance with stateand federal law, except, prior to July 1, 2003, where a prescriber haspersonally written "dispense as written" or "D.A.W.", or has signed theprescriber's name on the "dispense as written" signature line in accordancewith K.S.A. 65-1637, and amendments thereto.
(c) The Kansas health policy authority shallconsider the net economic impact ofdrugs selected or excluded from the preferred formulary and may gatherinformation on the costs of specific drugs, rebates or discounts pursuant to 42U.S.C. 1396r-8, dispensing costs, dosing requirements and utilization of otherdrugs or other medicaid health care services.
(d) The Kansas health policy authority may accept allservices, including, but not limited to, disease state management, associatedwith the delivery of pharmacy benefits under the state medicaid program havinga determinable cost effect in addition to the medicaid prescription drugrebates required pursuant to 42 U.S.C. section 1396r-8.
(e) The state medicaid preferred drug formulary shall be submitted to themedicaid drugutilization review board for review and policy recommendations.
History: L. 2002, ch. 180, § 1;L. 2005, ch. 187, § 27;L. 2005, ch. 187, § 56; July 1, 2006.