2565-S AMH SLAT BLAC 091

SHB 2565 - H AMD 907

By Representatives Slatter, Schmick

ADOPTED 02/09/2018

    On page 1, line 16, after "of" strike "drugs and gene therapies" and insert "new drugs and innovative therapies compared to other equally effective, more conservative, or substantially less costly courses of treatment that are available or suitable"

    On page 1, line 19, after "chapter." insert "Any consideration of the cost of the drug by the drug utilization review board must reflect: (a)  the total cost of care associated with the course of treatment for which the drug is prescribed, such as transportation, housing and treatment of adverse events; (b) costs to the state medical assistance program that may be incurred if the patient does not receive the prescribed course of treatment; and (c) examples of other services offered through the state medical assistance program that could be funded. To the extent that the drug utilization review board has mutual membership and jurisdiction with the pharmacy and therapeutics committee established by the authority pursuant to RCW 70.14.050, the drug utilization review board's recommendations and conclusions related to cost-effectiveness shall be separated from the deliberations of the pharmacy and therapeutics committee."

    On page 2, after line 2, insert the following:

    "(4) For the purposes of this section, the term "course of treatment" may include mere observation or, where appropriate, no medical treatment at all."

EFFECT:   Requires the Drug Utilization Review (DUR) Board, when considering new drugs and innovative therapies, to consider the safety, efficacy, and cost-effectiveness in comparison to equally effective, more conservative, or substantially less costly courses of treatment that are available or suitable.

Requires the Drug Utilization Review (DUR) Board's considerations of a drug's cost to reflect (1) the total cost of care associated with the course of treatment, (2) costs to the state medical assistance program that may be incurred if the patient does not receive the course of treatment, and (3) examples of other services offered through the state medical assistance program that could be funded. Specifies that the term "course of treatment" may include mere observation or no medical treatment.

Requires that the DUR Board's recommendations and conclusions related to cost-effectiveness be separated from the deliberations of the Health Care Authority's Pharmacy and Therapeutics (P&T) Committee to the extent that there is mutual membership between the DUR Board and the P&T Committee.

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