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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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!!!
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.
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.