Virginia Senate Bill SB592

Virginia 2025 Regular Session

• Introduced: 1/10/24
• Refer: 1/10/24

Caption

Preferred Drug List/Common Core Formulary; approval of a nonpreferred drug.

Impact

The passage of SB592 could lead to an important shift in how patients access medications covered under medical assistance in Virginia. By removing the prior authorization hurdles related to nonpreferred drugs, it may promote better health outcomes for patients who cannot tolerate certain medications. This legislative change implies that patients will have greater autonomy over their treatment options and medical providers will have more flexibility in prescribing suitable therapies without worrying about procedural delays related to drug approvals.

Summary

SB592 is a legislative bill aimed at reforming the procedures surrounding the approval of nonpreferred drugs for patients under the Virginia Medical Assistance Services. Specifically, the bill proposes to eliminate the requirement that a patient must try and fail a drug from the Preferred Drug List or Common Core Formulary within six months prior to requesting approval for a nonpreferred drug. This change is particularly significant for patients who have previously experienced harmful side effects with drugs on the Preferred Drug List. By easing these restrictions, SB592 seeks to enhance access to necessary medications for patients who require alternatives due to intolerable side effects.

Contention

Despite its potential benefits, SB592 may face opposition from stakeholders concerned about the financial implications for the state’s healthcare budget. Critics may argue that loosening the criteria for accessing nonpreferred drugs could lead to increased costs for the state, as more patients may opt for these alternatives that are not listed as preferred medications. As a result, the debate may center around balancing patient safety and choice against potential fiscal impacts on the state's medical assistance programs.