1. It’s not just a Preferred Drug List… It’s the Transformation of the Virginia Medicaid Pharmacy Program Bryan Tomlinson Department of Medical Assistance Services September 11, 2003 Richmond, Virginia

2. 2 Information Technology Professional Staffing Managed Rx Drug Benefits Expert Panels VA’s New Medicaid Pharmacy Program Integration of

3. 3 Restructured Professional Staffing Pharmacy Manager Staff Pharmacists Contract Manager Program Technician Rebate Expertise

4. 4 Information Technology VAMMIS FirsTrax First I Q FirstRebate

5. 5 Managed Rx Drug Benefits Preferred Drug List Prior Authorization (PA) Drug Utilization Reviews Threshold PA (unique drugs over 9) Quality Enhancements

6. 6 Integrated Expert Panels Pharmacy & Therapeutics Committee Drug Utilization Review Board Pharmacy Liaison Committee Association/Advocacy Groups PDL/PA Implementation Advisory Group

7. 7 The Transformation Sophisticated IT Operating & Decision Support Systems Advanced Managed Pharmacy Practices Enhanced Decision-Making Support from Expert Panels Improved Pricing Arrangements Focused Quality & Patient Safety Initiatives Dynamic Leadership & Professional Staffing