By Melissa Brewster, PharmD BCPS
This year has seen a lot of changes for the Oregon Health Plan (OHP) and the coverage of medications for Medicaid patients. Some notable 2019 changes:
- Acne is now a covered condition for OHP and many acne medications are covered by CPCCO
- Hepatitis C prior authorization criteria continue to shift, making it much easier to get treatment regardless of the disease severity
- Vivitrol criteria were significantly loosened, making it easier for patients to access treatment for alcohol and opioid use disorder
As always, thinking about the evidence and cost-effective care in clinical decision making regardless of expanded coverage is important. We will continue to discuss these concepts and recommendations with the Clinical Advisory Panel and local organizations.
Looking ahead into 2020, we are expecting some changes that will make getting medications to support recovery from substance use disorders easier. We are expecting our Pharmacy and Therapeutics Committee to review some big changes that would:
- Add buprenorphine films to formulary without prior authorization
- Remove the prior authorization for Vivitrol when acquired and administered by a clinic
Stay tuned to hear more about these potential changes and how they could impact your practice!
CareOregon also hosted three sessions of their education series for health care professionals, MedsEd. This year’s MedsEds focused on sleep apnea, trauma-informed care for substance use disorders, and COPD. All content from previous MedsEd programs is available online at careoregon.org/MEDSEd