Drug Costs
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New CBO Study Compares Net Prices for Brand-Name Drugs Among Federal Programs, Finds Medicaid Gets Largest Discounts
In a new groundbreaking study, the Congressional Budget Office compared brand-name drug prices, net of rebates and discounts, across select federal programs and agencies including Medicaid, Medicare Part D and the Department of Veterans Affairs (VA). It found that Medicaid gets the lowest net prices, far below that of Medicare Part D plans and well…
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CBO Estimates Confirm Lifting Medicaid Drug Rebate Cap Results in Significant Federal and State Savings
On Monday, February 22, the House Budget Committee plans to mark up the House COVID-19 relief reconciliation bill, with the full House possibly voting on the bill later in the week. As I have previously explained, one sound Medicaid provision — section 3107 of the bill —would, as of January 1, 2023, eliminate the current…
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House Energy and Commerce Committee Reconciliation Legislation Includes Sound Medicaid Drug Rebate Provision
Last night, the House Energy and Commerce Committee unveiled its recommendations for the House COVID-19 relief reconciliation bill, with a markup scheduled for February 11, 2021. One sound Medicaid provision would, as of January 1, 2023, eliminate the current cap on total drug rebates that manufacturers must pay state Medicaid programs, which would produce significant…
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Not All Seniors To Get $200 Medicare Drug Cards Before Election
Inside Health Policy By: John Wilkerson Only some seniors will receive the president’s $200 Medicare Part D cards for copays before the election because it will take months to issue the cards, White House officials said Friday (Sept. 25). Officials declined to say how the cards would be paid for, but on a call with…
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State-imported drugs would not affect 340B drug prices
Modern Healthcare By: Rachel Cohrs Drugs imported by states under the Trump administration’s importation plan will not be subject to Medicaid rebates, which means they would not set new 340B prices according to CMS guidance released Friday… The savings from drug importation would hinge on how low states could get drug prices and how widely…
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Health officials scramble to explain details of Trump’s $200 drug discount card
The Washington Post By: Lenny Bernstein Health officials scrambled Friday to explain President Trump’s plan to send $200 prescription drug discount cards to 33 million Medicare recipients as experts cast doubt on the proposal and Democrats accused the president of blatant political chicanery less than six weeks before the election… With little information to go…
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California Rx: State May Dive Into Generic Drug Market
Kaiser Health News By: Angela Hart and Samantha Young California is poised to become the first state to develop its own line of generic drugs, targeting soaring drug prices and stepping into a fiercely competitive drug market dominated by deep-pocketed pharmaceutical companies… “Other legislative efforts in Congress and in other states have focused on government…
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CCF Comments to Trump Administration Medicaid Drug Rebate Rule
CCF has submitted public comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed Medicaid drug rebate rule which, among other things, would change how drug manufacturers report “best price” under the effective Medicaid Drug Rebate Program. As I have explained, the proposed rule’s best price reporting changes are intended to facilitate…
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Why the coronavirus drug remdesivir costs $3,100
Vox By: Dylan Scott Remdesivir, the antiviral drug that appears to reduce the recovery time for hospitalized Covid-19 patients, has a price tag: $3,120 for the typical five-day regiment for a patient on private insurance. Gilead, the drug’s manufacturer, announced the news on Monday…. Edwin Park at the Georgetown Center on Children and Families told…
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Short-Term Funding Bill Keeps Government Open, Also Includes Sound Provision Reducing Federal and State Medicaid Drug Costs
On September 29, the President signed into law a fiscal year 2020 appropriations bill (H.R. 4378) that temporarily funds the federal government through November 21. The bill also includes several short-term extensions of critical health provisions that were scheduled to expire: full Medicaid funding for Puerto Rico and the other territories, a delay in scheduled…
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Senate Finance Committee Considers Bipartisan Bill to Lower Federal and State Medicaid Drug Costs
Editor’s Note: The Senate Finance Committee reported the bill on July 25, 2019 (without substantive changes to its Medicaid provisions.) On Thursday, July 25, the Senate Finance Committee is scheduled to consider bipartisan drug pricing legislation (known as the Prescription Drug Pricing Reduction Act). While much of the bill focuses on provisions related to Medicare…
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Trump Administration Withdraws Harmful Drug Rebate Safe Harbor Rule
On July 10, the Trump Administration announced that it would withdraw a proposed rule to eliminate the safe harbor in the federal anti-kickback law for rebates negotiated by pharmacy benefit managers (PBMs) on behalf of Medicaid managed care plans and Medicare Part D plans. This is a highly welcome move. As we have explained since…
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State Medicaid Programs Already Have Considerable Flexibility to Adopt Innovative Payment Models for New High-Cost Prescription Drugs
As I have previously warned, the ongoing prescription drug pricing debate could intentionally or unintentionally lead to significant harm to the Medicaid program and its effective Drug Rebate Program. That, in turn, could result in higher federal and state Medicaid drug costs and reduced beneficiary access to needed medications. One key element of the Medicaid…
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CCF Comments to Administration’s Harmful Rebate Safe Harbor Rule
We submitted comments to the Trump Administration’s proposed regulation to eliminate the safe harbor in the federal anti-kickback law for rebates negotiated by pharmacy benefit managers (PBMs) on behalf of Medicaid managed care plans (and Medicare Part D plans). As we have previously written, the proposed regulation raises serious concerns because it would likely…
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Trump Budget Includes Harmful Medicaid Drug Rebate Proposal, Several Sound Improvements
On March 11, the Trump Administration released its fiscal year 2020 budget. As my colleague Andy Schneider has written, the Administration budget plan would repeal the Affordable Care Act’s Medicaid expansion, impose a per capita cap or block grant on the rest of the Medicaid program, require all states to adopt onerous work reporting requirements…
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Clearing Up Confusion about the Medicaid Rebate Program: Part III
As federal efforts to address prescription drug costs intensifies, this three-part blog series addresses misleading claims or confusion about Medicaid, its highly effective drug rebate program and overall drug pricing issues in the hopes of better informing the debate moving forward. Part I | Part II Medicaid’s best price requirement is not the reason why…
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Clearing Up Confusion about the Medicaid Rebate Program: Part II
As federal efforts to address prescription drug costs intensifies, this three-part blog series addresses misleading claims or confusion about Medicaid, its highly effective drug rebate program and overall drug pricing issues in the hopes of better informing the debate moving forward. Part I | Part III Aggressive negotiation and closed formularies are only one factor in…
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Clearing Up Confusion about the Medicaid Rebate Program: Part I
As federal efforts to address prescription drug costs intensify, this three-part blog series addresses misleading claims or confusion about Medicaid, its highly effective drug rebate program and overall drug pricing issues in the hopes of better informing the debate moving forward. Part II | Part III In response to federal Medicaid rebate increases, drug manufacturers would…
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Risks to Medicaid Surface in Drug Pricing Debate
As the debate over prescription drug pricing heats up, I have been worried for a while that some of the federal policy solutions being considered in Congress and in the Administration could adversely affect Medicaid and its highly effective rebate program, whether inadvertently or intentionally. This could result in higher Medicaid drug costs, reduced beneficiary…
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New CCF Issue Brief on Strengthening Effective Medicaid Drug Rebate Program
Today, we issued our fifth issue brief in our Future of Children’s Health Coverage series. It focuses on how to build upon and improve the Medicaid Drug Rebate Program at both the federal and state levels in order to help state Medicaid programs better address their rising prescription drug costs. This, in turn, would ensure continued…
