FISCAL NOTE

Date Requested: January 25, 2016
Time Requested: 04:57 PM
Agency: Public Employees Insurance Agency (PEIA)
CBD Number: Version: Bill Number: Resolution Number:
1895 Introduced HB4146
CBD Subject: Health


FUND(S):

2180

Sources of Revenue:

Special Fund

Legislation creates:

Neither Program nor Fund



Fiscal Note Summary


Effect this measure will have on costs and revenues of state government.


The purpose of this bill is to provide insurance coverage for abuse-deterrent opioid analgesic drugs and set the maximum cost sharing for the drugs. PEIA currently covers abuse-deterrent opioid analgesic drugs in two of its three tiers of drugs. The impact of this bill will be the movement of the third tier/non-formulary drugs to the second tier/formulary drugs. This movement will increase costs to the plan by the difference between the member co-pays of the tiers. The second tier/formulary co-pay is $25 and the third tier/non-formulary drug is 75% of the drug cost. PEIA assumes all third tier abuse-deterrent opioid analgesics will increase in utilization by 30% in fiscal year 2017 when the drugs will be available at the lower member cost. Subsequent years assume an increase of 10%, consistent with average pharmacy trend assumptions.



Fiscal Note Detail


Effect of Proposal Fiscal Year
2016
Increase/Decrease
(use"-")
2017
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 69,789 69,789
Personal Services 0 0 0
Current Expenses 0 69,789 69,789
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0


Explanation of above estimates (including long-range effect):


PEIA assumes all third tier abuse-deterrent opioid analgesics will increase in utilization by 30% in fiscal year 2017 when the drugs will be available at the lower member cost. Subsequent years assume an increase of 10%, consistent with average pharmacy trend assumptions. The estimated fiscal impact is outlined below over the next 3 years: 2017 2018 2019 $69,789.80 $76,768.78 $84,445.66 3 Year Total $231,004.25



Memorandum






    Person submitting Fiscal Note: Jason Haught
    Email Address: jason.a.haught@wv.gov