LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              March 21, 2001
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB1116  by Maxey (Relating to establishing a maximum
               sales price for drugs sold to certain entities.), As
               Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB1116, As Introduced:  positive impact of $703,000 through the       *
*  biennium ending August 31, 2003.                                      *
*                                                                        *
*  The bill would make no appropriation but could provide the legal      *
*  basis for an appropriation of funds to implement the provisions of    *
*  the bill.                                                             *
**************************************************************************
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2002                             $329,000  *
          *       2003                              374,000  *
          *       2004                              418,000  *
          *       2005                              469,000  *
          *       2006                              522,000  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
         *****************************************************
         * Fiscal Year       Probable Savings to General      *
         *                          Revenue Fund              *
         *                              0001                  *
         *      2002                                 $329,000 *
         *      2003                                  374,000 *
         *      2004                                  418,000 *
         *      2005                                  469,000 *
         *      2006                                  522,000 *
         *****************************************************
  
Fiscal Analysis
  
The bill would prohibit a person from selling a drug to a public entity
for more than the reimbursement rate for the Medicaid Vendor Drug
Program.
  
  
Methodology
  
The term "public entity" is not defined in the bill.  It is assumed to
apply to state agencies.

It is estimated TDH would realize General Revenue savings related to the
purchase of prescription drugs provided through the following programs:
South Texas Hospital, Texas Center for Infectious Disease, Primary Health
Care, Hansen's Disease, and Refugee Health Screening.  Savings related
to the South Texas Hospital and the Texas Center for Infectious Disease
would total $249,000 in FY 2002, $294,000 in FY 2003, $338,000 in FY
2004, $389,000 in FY 2005, and $442,000 in FY 2006.  Combined savings for
the Primary Health Care, Hansen's Disease, and Refugee Health Screening
programs would total $80,000 each year.

Other Potential Impacts:
It is unclear whether the bill would have a fiscal impact on state
agencies and institutions that purchase prescriptions through
intermediaries or  provide a reimbursement for the purchase of a
prescription.  The Employees Retirement System (ERS) and the Teacher
Retirement System (TRS) have indicated the bill as introduced would not
apply to their health insurance programs.

A preliminary analysis of the unit cost on selected drugs indicates the
purchase price or reimbursement level provided by ERS, TRS, the
University of Texas System, and the Texas A&M University System was 38%
to 55% more on average than the amount paid by the Medicaid program.
This indicates a potential for General Revenue savings if these agencies
were to be included within the scope of the bill.
  
  
Local Government Impact
  
If "public entities" is meant to include counties, municipalities, and
districts, potentially, these entities could realize savings related to
the purchase of prescription drugs.
  
  
Source Agencies:   529   Health and Human Services Commission, 324
                   Texas Department of Human Services, 501   Texas
                   Department of Health
LBB Staff:         JK, HD, PP, SW