Comptroller Kevin Lembo said he has put restrictions in place on the state’s employee and retiree health plan that will save nearly $2 million a month on compounded drugs.
The new rules, enacted in May, require a doctor to certify that compound medications are medically necessary for a patient — such as someone with certain allergies — before the state’s health plan will pay for it, Lembo said.
Compounded medications, which pharmacists create by combining two or more drugs, include topical pain medications and anti-scarring creams. They are not tested by the U.S. Food & Drug Administration, Lembo said.
If the trend holds, the “prior authorization” requirement could mostly wipe out an increase in state spending on compounded medications over the past three years. Claims for compounded medications in the past year have totaled approximately $24 million, up from $800,000 in fiscal year 2012, according to Lembo.
Lembo said the rising costs are the result of aggressive marketing by out of state compounding pharmacies, which generated 91 percent of compounded drug claims in fiscal year 2014.
The Hartford Courant reported Monday that state employee unions are challenging the prior-authorization policy and have requested binding arbitration, which would begin next month unless the two sides can agree on a new policy first.
