§ 272. Preferred drug program. 1. There is hereby established a\npreferred drug program to promote access to the most effective\nprescription drugs while reducing the cost of prescription drugs for\npersons in state public health plans.\n 2. When a prescriber prescribes a non-preferred drug, state public\nhealth plan reimbursement shall be denied unless prior authorization is\nobtained, unless no prior authorization is required under this article.\n 3. The commissioner shall establish performance standards for the\nprogram that, at a minimum, ensure that the preferred drug program and\nthe clinical drug review program provide sufficient technical support\nand timely responses to consumers, prescribers and pharmacists.\n 4. Notwithstanding any other provision of law to the contrary, no\npreferred drug program or prior authorization requirement for\nprescription drugs, except as created by this article, paragraph (a-1)\nor (a-2) of subdivision four of section three hundred sixty-five-a of\nthe social services law, paragraph (g) of subdivision two of section\nthree hundred sixty-five-a of the social services law, subdivision one\nof section two hundred forty-one of the elder law and shall apply to the\nstate public health plans.\n 5. The drug utilization review board shall consider and make\nrecommendations to the commissioner for the adoption of a preferred drug\nprogram. (a) In developing the preferred drug program, the board shall,\nwithout limitation: (i) identify therapeutic classes or drugs to be\nincluded in the preferred drug program; (ii) identify preferred drugs in\neach of the chosen therapeutic classes; (iii) evaluate the clinical\neffectiveness and safety of drugs considering the latest peer-reviewed\nresearch and may consider studies submitted to the federal food and drug\nadministration in connection with its drug approval system; (iv)\nconsider the potential impact on patient care and the potential fiscal\nimpact that may result from making such a therapeutic class subject to\nprior authorization; and (v) consider the potential impact of the\npreferred drug program on the health of special populations such as\nchildren, the elderly, the chronically ill, persons with HIV/AIDS and\npersons with mental health conditions.\n (b) In developing the preferred drug program, the board may consider\npreferred drug programs or evidence based research operated or conducted\nby or for other state governments, the federal government, or\nmulti-state coalitions. Notwithstanding any inconsistent provision of\nsection one hundred twelve or article eleven of the state finance law or\nsection one hundred forty-two of the economic development law or any\nother law, the department may enter into contractual agreements with the\nOregon Health and Science University Drug Effectiveness Review Project\nto provide technical and clinical support to the board and the\ndepartment in researching and recommending drugs to be placed on the\npreferred drug list.\n (c) The board shall from time to time review all therapeutic classes\nincluded in the preferred drug program, and may recommend that the\ncommissioner add or delete drugs or classes of drugs to or from the\npreferred drug program, subject to this subdivision.\n (d) The board shall establish procedures to promptly review\nprescription drugs newly approved by the federal food and drug\nadministration.\n 6. The board shall recommend a procedure and criteria for the approval\nof non-preferred drugs as part of the prior authorization process. In\ndeveloping these criteria, the board shall include consideration of the\nfollowing:\n (a) the preferred drug has been tried by the patient and has failed to\nproduce the desired health outcomes;\n (b) the patient has tried the preferred drug and has experienced\nunacceptable side effects;\n (c) the patient has been stabilized on a non-preferred drug and\ntransition to the preferred drug would be medically contraindicated; and\n (d) other
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