State Comptroller Kevin Lembo said Monday that the state has been able to cut spending by about $2 million per month by implementing restrictions on the use of questionable compound drugs.
At a Hartford press conference, Lembo said the state had seen the use of compound drug claims skyrocket from $800,000 per year through 2012 to $24 million this year.
“So that will get anyone’s attention, under any circumstance,” Lembo said.
A new policy enacted May 15 requires state employees, retirees, and their family members on the state health plan to get prior approval to get access to these compound drugs. Lembo said the policy already has reduced spending on these drugs dramatically.
Before the policy was enacted, the state spent $3.1 million on compound drugs in April and just a few months later in July it was only spending $36,229. The number of prescriptions for these drugs also has dropped from 785 per month to 221 per month.
Lembo said it’s likely there will be additional savings for the state budget because the monthly claims included in the 2016 budget were still in the millions of dollars.
“The budget numbers assumed the new policy would have little or no impact,” Lembo said. “We are likely to see savings on the pharmacy side because of the implementation of this new protocol.”
Compound drugs are specialty drugs that combine two or more drugs and are made specifically for an individual. Some of the facilities these drugs are made at aren’t regulated by the U.S. Food and Drug Administration, he said.
However, not all compound drugs carry a risk, Lembo said, but many have not been tested to find out if they are medically necessary. For example, topical compound drugs are not approved by the FDA and “utilize ingredients that have not been tested for safety and efficacy in a topical form,” he said.
The drop in claims and the cost to the state can be attributed to a reduction in companies manufacturing the compound drugs.
Lembo said 91 percent of the compound drug claims to the state plan came from out-of-state compound pharmacies, and he reiterated that the drugs themselves also are “largely unregulated” by the U.S. Food and Drug Administration.
Connecticut is not the first state to restrict use of compound drugs.
“The precipitous increase in compound drug prescriptions, combined with uncertain safety and efficacy, have led large, self-insured groups like large public health plans — including state plans in neighboring Rhode Island, Massachusetts, and New York — to also limit compound drug prescription coverage,” Lembo said.