Utah health committee hears methods to redesign formularies to promote lower cost drugs


Patrick Jones


At their last Health and Human Services Interim Committee meeting, the Utah Legislature continued their conversation on efforts to lower and contain prescription drug prices. 

The committee heard from Milligram—a company that aims to find lower cost and high quality medications for employers and consumers—hoping to partner with the state of Utah to find lower cost drugs for Utah health plans. 


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Dr. Bruce Wolf, CEO and Founder of Milligram, said the state of Utah spent roughly $2 billion on pharmaceuticals annually with over 21 million prescription claims in 2017. Of the top 100 medications used in the US, Wolf claimed Utah could save up to $250 million annually using Milligram as an intermediary to find biosimilar and therapeutically equivalent medications. 

“We would do that by understanding where these margins are and then go to help the state redirect its formulary design,” Wolf said. “We could help the switch to therapeutic equivalent drugs and we also could help to focus on the sickest and costliest people in the Utah population.”

Wolf discussed drugs that help treat chronic obstructive pulmonary disease (COPD) as an example. According to Milligram’s 2017 analysis of Utah’s pharmaceutical industry, Advair—the most common drug used to treat COPD—costs $15.30 per day and Utah spent over $9 million on it. Breo—another COPD treatment that Wolf said is just as effective—costs $10.41 per day and the state spent $1.7 million on it.

Wolf claims that a switch to the cheaper Breo would save the state $3 million per year. 

“If you do the math, if you just switched Advair to Breo, you would save a third of the expense of [the medication] with just that one switch,” Wolf said. “That would probably entail just pushing a button.”

If Milligram were to work with the state of Utah, Wolf said they would start by analyzing the top 100 costly drugs on the state’s platform, design and implement new formularies with selected and lower cost drugs, provide clinical guidance on implementation, and provide on-going quarterly updates and advocacy for the state on their progress.

“We are not here to promote [our] app,” Wolf said. “We’re here to try to lower costs, first for patients, but also for the state and self-insured entities.”

The next committee meeting will take place on Aug. 17th.