1. 1 October 16, 2004

2. 2 Secretary of the Department of Administration, Chair Director of the Public Employees Insurance Agency Secretary of the Department of Health and Human Resources Commissioner of the Bureau of Medical Services (Medicaid) Commissioner of the Bureau for Senior Services Executive Director of the Workers Compensation Commission Licensed Pharmacist/Retail Pharmacy Representative Pharmaceutical Manufacturer with WV operations Primary Care Physician Representative of beneficiaries of the program Health Insurer with experience offering Rx coverage Membership

3. 3 Evaluate clearinghouse, recommend state agency to own and operate Create Drug Discount Card Program Develop Reference Pricing Schedule and Strategic Plan for Implementation Evaluate the Financial Impact of the Medicare Prescription Drug Improvement and Modernization Act of 2003 on West Virginia Commence negotiations to for multi-state agreements Report to legislature national aggregate data on advertising marketing costs Mandatory Duties

4. 4 Investigate purchase of Canadian drugs May pursue Federal Waivers May contract, may file suit May enter drug purchasing agreements with federal government, state agencies and subdivisions, other states and jurisdictions, large private sector purchasers Examine counter-detailing Explore disease-state management Explore licensing, continuing education, fees and procedures for drug- detailers Explore coordination of state payors Examine shared PDL among state payors/private purchasers Examine dispensing fees Discretionary Powers

5. 5 Recommends which state agency to operate clearinghouse 09/01/04 Recommends pricing schedule/strategy for implementation 09/15/04 Report on fiscal impact of the MMA on the State10/15/04 Annual report (every year)12/31/04 Manufacturers financially support clearinghouse until12/31/04 Clearinghouse transferred from manufacturers to State 06/30/05 Pharmaceutical Council sunsets07/01/08 Pharmaceutical Council determines the ability to establish a savings of 42% of the retail cost no date Timeline

6. 6 Recommends clearinghouse reside within the Department of Administration if State takes possession Recommends Cabinet Level Pharmacy Advocate Recommends central fill pharmacy as alternative to clearinghouse Clearinghouse Report

7. 7 Recommends using the Federal Supply Schedule as a benchmark for negotiations Recommends uniform PDL and streamlined prior authorization process Recommends buying consortia which includes private sector Recommends Cabinet Level Pharmacy Advocate Recommends virtual pharmacy as a failsafe to protect local pharmacies Reference Pricing Report

8. 8 200+ pages of partial regulations released on August 3, 2004 Unclear how many WVians and how much WVians benefit from the Medicare Discount Cards Unclear how many retirees will have their Rx coverage dropped by their former employer Hospitals appear to benefit in the short-term Doctors are protected in the short-term but face cuts for Rx administration in the next years Rx Council will issue periodic reports on the MMA MMA Report

9. 9 Status of State Discount Card 340b program review Detailing Status of Retail and Independent Pharmacies Other state agencies which purchase drugs Role of generic drugs Joint purchasing recommendations Pharmacy Collaborative Drug importation Office of the Pharmacy Advocate Annual Report

10. 10 Passed by the House and Senate on November 16, 2004 Authorizes the Council to proceed with the recommendations of the Reference Pricing Report Concurrent Resolution

11. 11 Signed by Governor Wise and Governor- elect Manchin on November 29, 2004 Creates the Cabinet Post of the Pharmaceutical Advocate Outlines the powers and responsibilities of the Pharmaceutical Advocate States that the post shall be filled by March 1, 2004 Executive Order 18-04

12. 12 Pharmaceutical Council Website www.wvc.state.wv.us/got/pharmacycouncil www.wvc.state.wv.us/got/pharmacycouncil Shana Kay Phares Chair, Pharmaceutical Council Deputy Secretary, West Virginia Dept. of Health and Human Resources sphares@wvdhhr.org (304) 558-7899 Closing