Frequently Asked Questions
Q: Who will decide what drugs will be listed on the PDL?
A: The preferred drug list is developed by the Pharmacy and Therapeutics (P&T) Committee, a group of Alaska health care professionals, the Department of Health and Social Services (DHSS) and Magellan Medicaid Administration. The list may change over time, as costs and Alaskan’s health care needs change. The recommendations from the P&T Committee and supplemental rebate bids from drug manufacturers are used by DHSS to evaluate the placement of product on the PDL.
Q: How will a PDL help cut prescription drug costs?
A: Pharmacy costs will be reduced by a partnership with drug manufacturers, who will give supplemental rebates to reduce the cost of the drugs.
Q: What drugs will be on the PDL?
A: Drugs in specified drug classes will be approved for the PDL based on clinical efficacy, safety and cost.
Q: What about drugs not on the PDL?
A: Non-preferred drugs will require the prescriber to document the medical necessity of using the drug. Certain groups of recipients may be exempt from the PDL requirements – for example, certain age groups. Drugs in classes that are not included on the PDL are not subject to the non-preferred drug documentation requirements.
Q: When are the P&T meetings and when are drug classes reviewed?
A: The P&T Committee meets four (4) times a year on the third Friday of September, November, January and April. Meeting dates and a schedule for the year are usually posted during the summer. A detailed agenda for each meeting is posted noticed and posted online 30 days prior to the meeting.
Q: What do the different class colors mean?
A: The class colors represent the changes to the drug class since the last review and whether drug manufacturers can provide verbal testimony at the P&T meeting. “Red classes” have new medications added since the last review. Drug manufacturers may provide verbal testimony for products in a red class. “Blue classes” have no new medications, but one or more medication within the class has a new indication or warning. Manufacturers may provide verbal testimony for products in a blue class, but the information should be limited to the new information available. “Green classes” have no new medications or indications. Manufacturers cannot provide verbal testimony at the P&T meeting for products in a green class.
Q: How can manufacturers provide input on a reviewed product?
A: Manufacturers can provide information in a number of ways. Clinical information can be submitted for a reviewed product in writing using the Clinical Submission Form (available online). The clinical submission form must be submitted on or before the PhRMA submission date posted online. Information submitted in writing will be distributed with the materials to the P&T Committee members with their materials. Manufacturers may also provide verbal testimony at the P&T Committee meetings either in person or by phone. Verbal testimony is limited to 3 minutes per manufacturer per drug class and is only allowed for red or blue classes. The State will not solicit industry comment beyond the Clinical Submission Form posted online; the decision to provide written information or verbal testimony is up to each manufacturer. Public comment submitted by providers that have been compensated by a manufacturer must have the relationship with the manufacturer clearly stated and will be treated as manufacturer submitted written information. Any written information submitted by a manufacturer after the PhRMA submission date will not be distributed to the P&T Committee members.
Q: How can the public and uncompensated practitioners provide comments on a reviewed medication or drug class?
A: Public comment may be submitted prior to the committee meeting in writing prior to Erin Narus at 4501 Business Park BLVD, Building L, Anchorage, AK 99503, via email at email@example.com, or via fax at (907) 561-1684. Public comment from recipients and practitioners will also be taken at the beginning of the P&T Committee meetings either in person or via phone. If a provider is compensated to submit comment or testimony the relationship between the provider and manufacturer must be clearly stated and the comments will be treated as verbal testimony or written information submitted by a manufacturer and not as public comment.
Q: Where can I find out more about the PDL?
A: Providers or recipients may contact Erin Narus, Pharm.D, at (907) 334-2425 or email to firstname.lastname@example.org with questions. Manufacturers or industry representatives must contact the Magellan Medicaid Administration Technical Call Center or Rebate Unit with all questions regarding coverage or claims processing questions.
Q: Can a manufacturer request a meeting with a representative of Health Care Services to share new clinical or financial information?
A: Yes; Pharmaceutical Manufacturers may request a meeting with the Pharmacy Program Manager, Erin Narus, to share new clinical, outcomes, or financial data for their product(s). All meetings must be requested in advance by sending an email to email@example.com. All meetings will occur on the last Tuesday of the month between 1:00pm and 4:00pm and will last for no more than 30 minutes in length. Meetings will be scheduled on a “first come, first served” basis. Meeting will be scheduled no more often than once every six (6) months per manufacturer. This policy applies to in-person meetings, conference calls and webinar presentations. This policy does not apply to the submission of clinical information to the Pharmacy and Therapeutics Committee by manufacturers using the Submission Request Form for Pharmaceutical Manufacturers form.