DRUG COSTING STATE

PEIA's Spending On Oxycontin Up 38 Percent

Wednesday July 04, 2001; 10:15 AM As law enforcement and drug
rehabilitation professionals grapple with widespread abuse of the
painkiller OxyContin, the amount the state spends on the drug
continues to climb.

Delegate Mary Pearl Compton, D-Monroe, said the state should look
into its rising OxyContin costs. She is chairwoman of the house
committee on health and human resources.

The Public Employees Insurance Agency spent 38 percent more on
OxyContin in the first 11 months of the 2000-2001 year than it did in
the entire 1999-2000 financial year.

That's an increase from $589,000 to $812,000.

In their lists of drugs they spend the most on, the state Medicaid
program and the Workers' Compensation Division have both ranked the
drug in their top five.

Despite the rising costs and concerns about abuse, legislators and
state officials say the drug is very good when used as it was
intended.

"You would hate to deny anybody use of a drug that is certainly
beneficial to their health, and in killing pain, it's certainly one
that does," said Sen. Roman Prezioso, D-Marion, chairman of the
Senate's committee on health and human resources.

That's part of the reason that when PEIA adopted a new list of
preferred drugs, OxyContin was on it. PEIA members pay $15 for a
33-day supply of drugs on the preferred list and $25 for drugs that
are not on the list.

"If a person is cancer-stricken and they're terminal, that drug is
very effective in pain remediation, and in that situation if its
prescribed for what it's intended to do, we don't have any problems,"
said PEIA director Tom Susman.

"Unfortunately, it's become a drug of high abuse," said Felice
Joseph, pharmacy benefits administrator for the agency.

Susman said the agency is not encouraging the drug's use by keeping
it on the preferred provider list. In fact, he said, the agency
recently instituted a program it hopes will clamp down on abuse of
OxyContin and other drugs.

A letter he sent out in May outlined the program for the doctors the
agency works with.

"The impetus for this program is the escalating use of OxyContin and
other narcotics by citizens of West Virginia, as well as other states
across the country," Susman wrote.

The letter says PEIA's prescription drug benefits manager,
Merck-Medco, will contact doctors with patients who are using more
than one doctor for controlled substance claims in a given
three-month period.

Merck-Medco also will contact doctors with patients who ask for more
than four controlled substances per quarter, or who are receiving
more than 120 days of therapy with a controlled substance.

"It is our intention to proactively manage the use of this narcotic
before PEIA is faced with the increases that Medicaid and Workers'
Compensation have seen in (their) expenditures," Susman wrote.
"Therefore, PEIA will be continually monitoring the utilization of
OxyContin."

Susman said despite the sharp increase in the past year, OxyContin
doesn't rank in the top 25 of PEIA's list of drugs it spends the most
money on.

He said the agency spent $85 million on drugs this year. It spent
$812,000 on OxyContin in the first 11 months of the 2000-2001 fiscal
year.

Joseph said the drug never appears in PEIA's top 10 list. She said
PEIA's 168,000 members are more likely to use cholesterol or diabetes
medications than painkillers.

Susman said he believes increased awareness of OxyContin abuse helped
bring PEIA's spending on the drug down in the closing months of the
last financial year, though he hadn't seen month-by-month numbers yet.