Updated at 11:03 a.m.
The Vermont State Employees’ Association denounced a decision by Gov. Phil Scott’s administration that will make it more difficult for its members to access certain prescription drugs.
The governor’s administration sent the union a list of nearly 170 medications that, beginning next January, will be excluded from state workers’ health insurance plans. That means current and retired employees will either have to switch to a cheaper alternative, if one exists, or file an appeal to continue receiving their medication.
The list includes a number of common drugs such as Adderall, blood glucose meters and test strips, EstroGel, Prozac, Valium and Xanax.
“They’re putting their desire to save money over the medical needs of retirees and state employees and their families,” said VSEA executive director Steve Howard.
Since the union began publicizing the list of excluded drugs Tuesday morning, Howard claimed that its offices have been “inundated” by calls from members who rely on such prescriptions. Referring to the administration, he added, “I’m not sure they fully understand what kind of pain they’re gonna cause for a large number of Vermonters across the state.”
Instead of using a custom list of preferred drugs, the state is switching to the standard list offered by its pharmacy benefits manager, according to Department of Human Resources deputy commissioner Dan Pouliot. “Most employers throughout the country adopt and use the national formularies that are offered by the pharmacy benefits managers,” he said.
Pouliot said that most of the excluded drugs are “very expensive and also have less expensive generic equivalents.” He emphasized that members will have the option of appealing if they’re denied a prescription they depend upon.
The change will save the state about $600,000 annually, according to the Department of Human Resources. It comes after the Vermont Labor Relations Board ended a stalemate in contract negotiations between the state and the union, ruling last week in the administration’s favor. Under the new contract, VSEA members will also have to pay more for copays and deductibles.
Read the entire list of excluded drugs here:
Correction, April 4, 2018: This story was updated to note that the drugs on the list are “excluded,” meaning patients would have to win an appeal to receive any insurance coverage for the drugs.
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Steve Howard’s Hair looks fantastic in the cover picture.
Mr. Scott, as a newly retired state employee who has thought about maybe voting you in, in November I can tell you that wont happen… I will not consider you our governor just because you hold the title. You have lied and cheated your state employees… you are not someone that Vermont State Employees want in their corner… State employees are over worked and under paid.. after 30 years of employment this is the way you treat your retirees?
I for one will be elated when you are not voted in again in November… and remember you did this to your self.
I think it’s important to note the reported $600,000 in savings makes changes to a plan that will affect more than 30,000 state employees, spouses, children and retirees. Many of these newly ‘banned’ medications are prescribed to treat chronic illnesses: Lupus, MS, Cancer and Chemotherapy Medications, Pain Medication, Addiction treatment, Mental Health…the list goes on. To add insult to injury we have been told this is only a partial list with more entries to come. Our health plan is a benefit that attracts and retains employee to state employment. Silly me for actually thinking/believing our Governor was seriously trying to find solutions to his CONSTANTLY repeated 6,3,1 slogan (6 represents six fewer Vermonters in the workforce every day,”3 represents three fewer children every day in the public school system, 1 refers to the number of babies born every day to a mother addicted to drugs). Turns out it’s more important/lucrative to bring people in from other states than it is to take care of your own hardworking, taxpaying, VOTING Vermonters.
While $600,000 sounds like a lot of savings it is a drop in the bucket of the state budget. But will cost a lot of money for individual employees and retirees. I also cant imagine not covering epi pens as when needed those make the difference between life and death. I also question why drop coverage for many mental health and substance abuse drugs when this seems epidemic in this state.
“Yes, as through this world I’ve wandered
I’ve seen lots of funny men;
Some will rob you with a six-gun,
And some with a fountain pen.” ~ Woody Guthrie
Thank you Phil Scott!! Finally someone is standing up to VSEU. State employees receive great benefits that are usually beyond what everyone else receives. Every time someone stands up to these people, they scream, shout, and pout like they are being abused. Yet, they have great benefits and above average pay. Plus when you interact with State employees.. there’s always this entitled attitude. I hope the State continues to cut pay and benefits.. I’m tired of paying for it and providing all people their golden parachutes.
I suggest that Seven Days do a follow up article on this change 12 months after it goes into effect. We will then all be ale to see this will be a non issue for the union members and more a scare tactic used by Steve Howard and other union leaders to justify thier exorbitant salaries and existence. Thank you Govornor Scott for your fair and practical proposal.
So I notice all Glucose meters and test strips are now “Not covered” that’s great for all the Type 1 diabetic – months of paper work while the prove they are actually diabetics. Then add all the Type 2 diabetics and you will end up spending much more time on “administrative” costs for these people to get life saving (and public saving- you don’t want a diabetic driving with a low blood sugar because they can’t afford test strips) medical supplies.
Maybe readers should begin to look at the State for what it is, an Incorporated For Profit enterprise.
A number of the drugs / products as listed ARE generics. Testosterone and glucose test strips are not brands. WTF, so diabetics cannot get their glucose test strips covered any longer? Or they need a doctor’s note to prove they are diabetic? Test strips are not something that is abused, over prescribed or subject to black market forces. This is ridiculous. If your are prescribed insulin, then you need these companion test strips to ensure you don’t succumb to an insulin OD which can be deadly. My friend’s son just died a couple hours ago due to insulin OD, crashing his blood sugar levels to the point of brain death. This has to be a mistake. What is going on here?
John Brabant: Yes. But if you look closely, also on the full list are ‘blood glucose monitors’ both generically like that and some spelled out specifically by brand, and Novolog – which is insulin.
The problem with this list is that many of the drugs are life-saving drugs where there is no alternative to be used. One of these drugs on the list is Kineret also known as Anakinra. This is a biologic drug that has saved many lives as it prevents swelling in the body in certain rare diseases. The approval process can take so long that the patient is in the ICU by the time the insurance company goes through the new review process. This in the long run costs the patient and the state insurance pool much more money than just covering the drug up front. This drug can easily cost over $5,000 per month out of pocket.
A good amount of these drugs listed are over the counter drugs which are not covered usually by any insurance carrier, and the diabetes meters and testing supplies, even MediCare does not pay for. SO what are they crying about?? Most drug coverages nowadays mandate that the alternate generic drug be used anyway, unless no generic is available. In that case they would need to consult the doctor for a new alternative, or a letter of appeal to continue the same drug.
My own coverage did this at the beginning of 2018. They came out with their approved”Formulary” drug list.
State of Vermont Employees, your just spoiled rotten, and the State is just fighting back to avoid supplementing “BIG PHARMA” so stop bitching!!!