PRINTER'S NO. 4713
No. 745 Session of 2002
INTRODUCED BY MANN, FLICK, MELIO, CALTAGIRONE, SANTONI, O'BRIEN, KENNEY, SCAVELLO, BROWNE, FORCIER, HARHART, DALLY, CRUZ, YOUNGBLOOD, LEDERER, KELLER, McGEEHAN, MANDERINO, YUDICHAK, STURLA, STEELMAN, CURRY, MICOZZIE, ADOLPH, CIVERA AND BARRAR, NOVEMBER 26, 2002
INTRODUCED AS NONCONTROVERSIAL RESOLUTION UNDER RULE 35, NOVEMBER 26, 2002
A RESOLUTION 1 Urging the Secretary of Public Welfare and the Governor to 2 rescind implementation of the draft Medical Assistance 3 Bulletin for prior authorization of COX-2 inhibitors 4 scheduled to go into effect on January 6, 2003. 5 WHEREAS, There is great concern among arthritis sufferers 6 regarding a draft Medical Assistance Bulletin scheduled to go 7 into effect on January 6, 2003, which if issued by the Secretary 8 of Public Welfare would impose severe restrictions on access to 9 first-line medications used in the treatment of osteoarthritis, 10 rheumatoid arthritis and pain in the fee-for-service Medicaid 11 program; and 12 WHEREAS, According to the Arthritis Foundation and the 13 National Institutes of Health, arthritis is a painful and 14 physically debilitating chronic disease that affects one of 15 every three Pennsylvanians; and 16 WHEREAS, Individuals with arthritis need access to 17 comprehensive health care that includes the so-called COX-2
1 inhibitor medications; and 2 WHEREAS, The new generation of COX-2 inhibitor medications 3 was developed to treat the pain of arthritis without the 4 gastrointestinal complications, such as ulcers and bleeding, 5 associated with older medicines such as ibuprofen; and 6 WHEREAS, At least 16,000 osteoarthritis and rheumatoid 7 arthritis patients die in the United States each year due to 8 causes related to nonsteroidal anti-inflammatory drugs (NSAIDs); 9 and 10 WHEREAS, In Pennsylvania, 254 patients died in 2000 from 11 NSAIDs bleeding, at a cost of more than $4.3 million; and 12 WHEREAS, The draft Medical Assistance Bulletin would force 13 physicians to try nonselective NSAIDs before a COX-2 inhibitor 14 medication for patients who are under 70 years of age; and 15 WHEREAS, The draft Medical Assistance Bulletin is in direct 16 conflict with the 2002 guidelines for treating osteoarthritis, 17 rheumatoid arthritis and persistent pain from the American 18 College of Rheumatology, American Geriatric Society and the 19 American Pain Society; and 20 WHEREAS, No exceptions are granted under the draft Medical 21 Assistance Bulletin for patients with previous history of 22 gastrointestinal upset from older NSAIDs or previous history of 23 gastrointestinal bleeding; and 24 WHEREAS, The draft Medical Assistance Bulletin fails to 25 provide a grandfather provision for existing patients who are 26 stable using COX-2 inhibitor medications; and 27 WHEREAS, The draft Medical Assistance Bulletin lacks 28 consistency with COX-2 inhibitor guidelines used in other 29 commercial health plans; and 30 WHEREAS, Medicaid programs in about half of the other states 20020H0745R4713 - 2 -
1 place no restrictions on the use of COX-2 inhibitor medications 2 because of the recognized superior safety profile of those 3 medications; and 4 WHEREAS, While the goal of the draft Medical Assistance 5 Bulletin may be to reduce drug costs in the Medicaid program, 6 the provisions with respect to COX-2 inhibitor medications may 7 not reduce total Medicaid costs and, as suggested by the 8 evidence, may lead to the opposite result; therefore be it 9 RESOLVED, That the House of Representatives urge the 10 Secretary of Public Welfare and the Governor to rescind 11 implementation of the draft Medical Assistance Bulletin for 12 prior authorization of COX-2 inhibitors scheduled to go into 13 effect on January 6, 2003. K25L82DMS/20020H0745R4713 - 3 -