COLUMBUS, Ohio (AP) — A decision by Ohio Gov. John Kasich to change the way doctors can bill Medicaid for an expensive painkiller addiction treatment may make it easier to obtain in the long run.
The administration says the change could ultimately affect far more patients than a $1 million pilot program for ex-offenders vetoed by the governor last month.
Under the new change taking effect in October, pharmacies can bill Medicaid directly for Vivitrol and have the drug delivered to a doctor’s office without an upfront payment.
That replaces the current system in which doctors must pay for Vivitrol injections out of pocket, then seek reimbursement through Medicaid, the state-federal health insurance program for poor children and families.
“Vivitrol shows promise,” said Eric Poklar, of Kasich’s Office of Health Transformation. “It’s a drug worth dispensing.”
Adding Vivitrol to the pharmacy benefit will eliminate barriers to prescribing, improve access for Medicaid beneficiaries and ensure better long-term treatment, Poklar said.
Ten other states now allow pharmacies to bill Medicaid directly for Vivitrol: Arizona, Connecticut, Florida, Maryland, Massachusetts, New Hampshire, New Mexico, New York, Washington and Wisconsin.
The drug, depot naltrexone, marketed as Vivitrol, is not new, but the application — a monthly shot in the buttocks — is seen as an alternative to older methods of treating heroin and painkiller addictions. But those injections can cost as much as $1,000 a month.
Proponents argue the drug is less expensive than the long-term price of dealing with addicts who move in and out of prison and through multiple rehab centers.
The $1 million pilot vetoed by Kasich last month would have paid for Vivitrol’s use before and after release by 150 inmates in Franklin and Scioto counties who are either alcoholics or addicted to heroin or painkillers.
Kasich said singling out Vivitrol contradicted his “all strategies forward” approach of tackling the painkiller problem.
The program advanced “one medication manufactured by a single company at the expense of other addiction treatment strategies and protocols that the administration and treatment providers could pursue,” Kasich said in his veto statement.
The U.S. Food and Drug Administration approved Vivitrol in October 2010 to treat and prevent relapse after patients addicted to drugs like heroin and painkillers have gone through detox. The drug, which blocks the drugs’ effects, was approved to treat alcohol dependence in 2006.
___
Andrew Welsh-Huggins can be reached at http://twitter.com/awhcolumbus.
