It’s not just a Preferred Drug List…

It’s the Transformation of the Virginia Medicaid Pharmacy Program

Bryan TomlinsonDepartment of Medical Assistance Services

September 11, 2003Richmond, Virginia

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Information Technology Professional Staffing

Managed Rx Drug Benefits

ExpertPanels

VA’s New Medicaid Pharmacy Program

Integration of

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Restructured Professional Staffing

•Pharmacy Manager

•Staff Pharmacists

•Contract Manager

•Program

Technician

•Rebate Expertise

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Information Technology

•VAMMIS•FirsTrax•First IQ•FirstRebate

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Managed Rx Drug Benefits

•Preferred Drug List

•Prior Authorization (PA)

•Drug Utilization Reviews

•Threshold PA (unique drugs over 9)

•Quality Enhancements

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Integrated Expert Panels

•Pharmacy & Therapeutics Committee

•Drug Utilization Review Board

•Pharmacy Liaison Committee

•Association/Advocacy Groups

•PDL/PA Implementation Advisory Group

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The Transformation

Sophisticated IT Operating & Decision Support Systems

Advanced Managed Pharmacy Practices

Enhanced Decision-Making Support from Expert Panels

Improved Pricing Arrangements

Focused Quality & Patient Safety Initiatives

Dynamic Leadership & Professional Staffing