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Ohio Department of Medicaid (ODM) Rolls Out New Unified Preferred Drug List

posted: March 20, 2020

The ODM began implementation of their Unified Preferred Drug List (UPDL) on January 1, 2020. According to the ODM, the UPDL was developed to reduce confusion, hassles, and potential delays for members in accessing their medications; and is one of the ODM’s goals to improve patient prescription adherence for those with chronic conditions. The ODM is solely responsible for managing the prescription drug benefits using a single PBM for the UPDL. The former way the ODM was handling the drug coverage for the state’s Medicaid patients involved allowing the state’s managed care organizations (MCOs) to have control over contracts with PBMs to manage their prescription drug benefits.

While OAR applauds the ODM for making strides to rein in PBM abuses, some confusion exists as to how the UPDL will be managed, and drugs will be chosen or removed from the UPDL. OAR’s concern stems from our organization’s 2020 goal to reform non-medical switching practices in Ohio through our involvement in advancing HB 418. Unclarities exist as to whether medications will be removed from the UPDL mid-year, or at any point in time once having been selected for coverage.

OAR knows that switching a patient abruptly from their treatments drives increases in health care costs and negatively impacts a patient’s wellbeing. We are calling on OAR members to aid us in conveying our concerns to the ODM by offering feedback and sharing any experiences you may have had already with the UPDL. Please contact OAR’s Government Affairs Specialist at Heather.Kazmark@naylor.com to aid us in this exploratory effort.

More information on the Unified Preferred Drug List (UPDL) can be found on the ODM website.