Drug Costs
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How to Strengthen the Medicaid Drug Rebate Program to Address Rising Medicaid Prescription Drug Costs
Fifth in a series of briefs on the future of children’s health care coverage Introduction Prescription drugs are essential for the health of tens of millions of low-income children enrolled in Medicaid. They not only are part of routine pediatric care but also provide critical treatment and maintenance for chronic conditions such as asthma and…
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Archived Webinar: Helping State Medicaid Programs Better Address Rising Drug Costs
This webinar reviews overall drug pricing trends, current beneficiary access protections, effectiveness of Medicaid Drug Rebate Program, and state strategies to address rising Medicaid prescription drug costs while maintaining access to needed drugs.
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Trump Administration Encourages States to Seek Waivers to Opt Out of Medicaid Drug Rebate Program
On June 27, the Centers for Medicare and Medicaid Services partially approved Massachusetts’ Medicaid waiver proposal, but among other provisions, rejected a proposal to impose a “closed formulary” for prescription drugs under which the state could entirely exclude coverage of certain drugs in ways not permitted under current law. Instead, CMS expressed openness to approving…
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CMS to Freeze Risk Adjustment Payments to Health Insurers
MedPage Today By: Joyce Frieden The federal government will stop making risk adjustment payments to health insurers that have sicker-than-average patients, raising the specter of more premium increases by insurers to make up for the shortfall. … Withholding the payments will have both short-term and long-term effects, according to Edwin Park, JD, of Georgetown University.…
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CMS denies Massachusetts’ request to choose which drugs Medicaid covers
Modern Healthcare By: Virgil Dickson The CMS has denied Massachusetts’ request to become the first state in the nation to determine which drugs it will cover in its Medicaid program. … If states do pursue the demo the CMS described, access to drugs could be harmed as it’s unlikely states will get discounts as deep as…
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CCF Comments to Trump Administration Drug Pricing Blueprint: How to Further Strengthen the Effective Medicaid Drug Rebate Program
In May, the Trump Administration unveiled its drug pricing blueprint and is now seeking public comments. We would like to share our submitted comments to the blueprint, which focus on Medicaid, and encourage you to submit your own comments by the July 16 deadline. Prescription drugs are essential for the health of tens of millions…
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Highly Misleading Claim on Medicaid and Drug Pricing Does Not Withstand Scrutiny
A recent report from the HHS Office of Inspector General found that Medicare Part D spending on brand-name drugs, net of rebates, increased by 62 percent between 2011 and 2015. For nearly half of all brand-name drugs reimbursed by Part D, unit costs increased by at least 50 percent and for 12 percent of such…
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Preliminary CBO Analysis Finds Medicaid Doing Far Better than Medicare in Addressing Rising Cost of Specialty Drugs
Last week, I wrote about how data from the recent Medicare Trustees report show the highly effective Medicaid drug rebate program continues to produce substantially larger rebates from drug manufacturers than private insurers in Medicare Part D do. Now, new preliminary data from an analysis conducted by the Congressional Budget Office similarly finds that Medicaid…
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MACPAC Report Recommends Sound Improvements to Medicaid Drug Rebate Program
On June 15, the Medicaid and CHIP Payment and Access Commission (MACPAC) issued its June 2018 Report to Congress on Medicaid and CHIP. The MACPAC report included recommendations for two sound, albeit modest, improvements to the highly effective Medicaid drug rebate program which could lower state and federal Medicaid prescription drug costs: Prevent manufacturers of…
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New Medicare Trustees Report Continues to Show Greater Effectiveness of Medicaid Drug Rebate Program Compared to Medicare Part D
As I’ve previously written, the Medicaid drug rebate program is very effective. It requires drug manufacturers to provide sizable rebates that significantly lower federal and state Medicaid prescription drug costs while ensuring access to needed medications for tens of millions of low-income beneficiaries. Last week, the Medicare Trustees issued their latest annual report on the…
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How Medicaid and CHIP Shield Children from the Rising Costs of Prescription Drugs
Nearly a quarter of U.S. children use at least one prescription drug a month, most commonly treating such conditions as asthma, attention deficit hyperactivity disorder, and infections. Medicaid guarantees that enrolled children who need drugs receive them without any financial barriers, while some in the Children’s Health Insurance Program have a modest copayment. This report, the third in a…
