Pfizer on Tuesday said that Florida saved $41.9 million over the 27-month period that ended in September 2003 as a result of a Medicaid disease management program provided by the company, the Orlando Sentinel reports (Groeller, Orlando Sentinel, 11/10). Under a contract announced in 2001, Pfizer agreed to establish care guidelines, pay case workers to monitor Florida Medicaid beneficiaries and communicate with physicians to help reduce the length of hospital stays. The contract exempted Pfizer from a 2001 state law that requires pharmaceutical companies to provide discounts on prescription drugs in addition to the rebate required under federal Medicaid law to have their products appear on state Medicaid prescription drug formulary (Kaiser Daily Health Policy Report, 7/27). About 150,000 Florida Medicaid beneficiaries participated in the Pfizer program. Pfizer based the estimated savings that Florida received from the program on an analysis of 20,000 participants conducted by the research group Medical Scientists (Dorschner, Miami Herald, 11/10). Pfizer in 2001 said that the program could save Florida $33 million (Orlando Sentinel, 11/10). According to Pfizer, the analysis indicates that the program reduced the number of physician visits among participants by 4.3%, visits to emergency departments by 5.7% and hospital stays by 9.7%. Pfizer officials said that the company spent $19.2 million to hire case managers, provide equipment and donate prescription drugs (Miami Herald, 11/10). Pfizer Chair and CEO Henry McKinnell said the company has discussed the launch of similar programs with other states and several employer groups. In addition, Pfizer could establish similar programs in Germany, Italy and Sweden, McKinnell said (Hensley/Hovey, Wall Street Journal, 11/9).

Florida Program Ended
Florida had extended the Pfizer program, which was scheduled to last two years under the original contract, until September 2005, but the Florida Legislature this year passed legislation that banned a link between disease management programs and preferential treatment on the state Medicaid prescription drug formulary. Florida lawmakers passed the legislation based on a report released by the state Office of Program Policy Analysis and Government Accountability that said such programs have raised some prescription drug costs in the state. McKinnell said, "This innovative public-private partnership that modifies the health care system and engages patients actively in their own care decisions is delivering exactly what it promised." Peter Brandt, senior vice president for Pfizer, added, "Perhaps Florida would have liked to see the results of the program" before state lawmakers decided to ban such programs.

Some Doubts
However, some critics questioned the validity of the analysis of the program reported by Pfizer. Bernard Horn, policy director at the Center for Policy Alternatives, said, "Pfizer is making tens of millions of dollars on this. By not paying the (drug) rebates, they keep it in their pocket in exchange for a program that has a marginal financial value" (Orlando Sentinel, 11/10). State Rep. Frank Farkas (R) said that the analysis provided by Pfizer is "hard to verify," adding, "We don't have any way to quantify these numbers objectively, and that's why we discontinued these programs" (Miami Herald, 11/10).