One is the Loneliest Number

As the fiscal year for the states winds down, we find 48 of the 50 states running budget deficits. Sole-sourcing continues to be an attractive way for state government to drive down its costs with respect to specialty pharmacy. Sole sourcing, sometimes called single-sourcing, is the idea that by reducing the number of vendors selling a product, the state can force greater concessions through economies of scale.
Washington State entertained a proposal for single sourcing, but grassroots community pressure forced state officials in Olympia to reconsider. Other states facing some kind of limitation on specialty pharmacy vendors include:

  • New York where the State is about to announce the names of the three vendors that will administer the state’s managed Medicaid program;
  • Vermont where the state’s office Vermont Health Access Program imposed a sole source contract for managed Medicaid patients with little community input last fall; and
  • Arizona is seeking comment in light of a proposal to consider sole sourcing for specialty pharmacy products including Hemophilia.

This list of various states is not inclusive of all the places around the country facing limits on access, regime and reimbursements, it is meant to provide a sense of the various threats single-sourcing presents to people in the bleeding disorders community. We should all be clear; any shift towards single-source contracts does in fact represent a threat. Single sourcing is troubling, because we as a community know all too well that abuses occur when medical decision-making falls into too few hands, regardless of whether they are in the public or private sector.