Drug Costs

Bipartisan Senate Finance Committee Legislation Includes Enhanced Medicaid Pharmacy Pricing Survey Provision

On November 8, 2023, on an unanimous 26-0 vote, the Senate Finance Committee approved the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act.  The bill includes a number of Medicare and Medicaid provisions but also incorporates two sound Medicaid drug pricing provisions related to “spread pricing” in Medicaid managed care and to Medicaid pharmacy […]

CBO Confirms House Bill Prohibiting Use of “QALYs” Would Undermine State Negotiation of Medicaid Supplemental Rebates

I previously raised significant concerns about a House health bill that would expand an existing Medicare prohibition on the use of Quality-Adjusted Life Years (QALYs) to other federal programs including Medicaid and the Children’s Health Insurance Program (CHIP).  I warned that the bill was overbroad in its prohibition of the use of QALYs and could […]

New Inspector General Report Finds Manufacturers Would Have to Pay Substantial Rebates if the Medicaid Drug Rebate Program Applied to Separate State CHIP Programs

The Office of Inspector General (OIG) at the Department of Health and Human Services issued a new report estimating that applying the Medicaid Drug Rebate Program (MDRP) to separate state CHIP programs would have resulted in drug manufacturers paying $641.2 million in rebates in calendar year 2020 alone, with the federal government receiving $515.7 million […]