Prescription Drugs: Medicaid
From Families USA:
President Bush's Fiscal Year 2007 Budget: Analysis of Key Health Care Provisions Includes discussion and commentary on Health Savings Accounts (HSAs), Medicaid, and Medicare. (February 22, 2006)
Gearing Up Series--The Holes in Part D: Gaps in the New Medicare Drug Benefit (Part 1 of 2) This brief discusses the three major kinds of gaps associated with the Part D benefit: 1) the financial gap beneficiaries will face; 2) the drug coverage gap; and 3) the enrollment gap. (July 2005)
Gearing Up Series--Filling the Holes in Part D: The Essential Role of State Pharmacy Assistance Programs (Part 2 of 2) This brief examines the key decisions states will have to make when determining how their Pharmacy Assistance Programs can provide wraparound coverage and explains the special role of these programs under the Medicare drug law. It also discusses how these programs can help with enrollment. (July 2005)
Gearing Up: States Face the New Medicare Law Is Your State Ready for 2006? An Introduction to What the New Medicare Part D Prescription Drug Benefit Means for Medicaid (September 2004)
Families USA Submits Written Testimony for the Senate Finance Committee Hearing on International Trade and Pharmaceuticals. The testimony argues that savings from safe prescription drug reimportation, along with other important reforms, can be used to preserve and improve the Medicare and Medicaid programs. (April 27, 2004)
Prescription Drugs in Medicaid: Achieving "Real" Cost Savings
From the Center for Policy Alternatives:
2001 Prescription Drug Pricing Legislative Summary- In the summer edition of its newsletter Alternatives, the Center for Policy Alternatives has published a prescription drug fair pricing legislative summary for 2001 as part of its compilation of legislative developments in progressive issues. This year, 27 state legislatures introduced fair pricing bills for prescription drugs similar in scope to Maine's landmark law, but more than 40 state legislatures were involved in providing solutions to the problem of escalating prescription drug prices. Those strategies include offering Medicaid prices to seniors, Medicaid waivers, creating or expanding senior pharmacy discount programs, supporting multi-state purchasing alliances, and setting prices at the lowest market rate available. (June 2001)
From the Center for Studying Health System Change:
More Nonelderly Americans Face Problems Affording Prescription Drugs finds that the proportion of children and working-age Americans who went without a prescription drug because of cost concerns reached 13.9 percent in 2007, up from 10.3 percent in 2003. Nearly one in four working-age adults with Medicaid or other state insurance reported having difficulties affording prescription drugs, while nearly three in 10 working-age Medicare beneficiaries reported having such problems. (January 2009)
State Prescription Drug Price Web Sites: How Useful to Consumers? examines the current push to make retail pharmacy prices accessible to consumers, which is part of a much broader movement to increase price transparency throughout the health care sector. To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. This study found that relying on Medicaid data resulted in extensive gaps in available price information and hampered the effectiveness of state drug price-comparison web sites. (February 2008)
Prescription Drug Access: Not Just a Medicare Problem presents the results of the 2000-2001 Community Tracking Study Household Survey. The survey found that 26 percent of Medicaid beneficiaries aged 18-64 couldn't afford to get a prescription filled in the previous year. According to the study, individual cost-control measures-such as copayments, prior-authorization, and mandated generic substitution-do not appear to affect beneficiaries' access to prescription drugs, but when multiple cost-control measures are implemented, beneficiary access to prescription drugs is affected to a much greater extent. (April 2002) More detailed study results can be found in Affording Prescription Drugs: Not Just a Problem for the Elderly.
From the House Energy and Commerce Committee
The House Energy and Commerce Committee held a hearing titled Medicaid Prescription Drug Reimbursement: Why the Government Pays Too Much. Testimony was presented on how Medicaid reimbursement rates had resulted in overpayment for prescription drugs and on the need to bring drug costs down. Witnesses also presented strategies some states had used to contain Medicaid prescription drug costs. (December 7, 2004)
From the Kaiser Commission on Medicaid and the Uninsured:
Medicaid and Prescription Drugs is an updated fact sheet that summarizes the latest statistics and trends regarding the role of Medicaid in providing prescription drug coverage. (October 2002)
Medicaid and the Prescription Drug Benefit: Cost Containment Strategies and State Experiences provides background information on Medicaid and its prescription drug benefit. It also provides examples of how states are using the cost containment mechanisms at their disposal, and it addresses issues surrounding beneficiary access to outpatient drugs. (September 2002)
From The Kaiser Family Foundation:
Florida's Medicaid Prescription Drug Benefit: A Case Study focuses on the state's experience with a number of Medicaid prescription drug cost-control measures. Such measures include a 1997 disease management program, the four-brand drug limit imposed in 2000, and the recent passage of S792, which authorized the development of a preferred drug list. Florida's experience is important because other states are looking at it as a potential model. (February 2002)
States Strive to Limit Medicaid Expenditures for Prescribed Drugs presents trends in Medicaid spending for prescribed drugs through 2000, summarizes the flexibility states have in designing their drug benefits, and reviews several strategies that states are using to curb their Medicaid drug budgets. The brief also makes the point that the "federal government might be able to save the states-and itself-far more money than various state efforts to control utilization and garner additional rebates simply by deploying the program's leverage to ratchet up federal rebates." (February 2002)
Medicaid: Purchasing Prescription Drugs describes the federal regulatory framework within which states design and implement their Medicaid prescription drug benefits. This Policy Brief summarizes the flexibility available to state Medicaid agencies in designing a prescription drug benefit, controlling utilization, and paying for drugs. It goes on to describe the program under which drug manufacturers provide rebates to both the federal and state governments for the drugs Medicaid buys, and it reviews efforts in Maine and Vermont to extend the discounts achieved by the rebate program to non-Medicaid populations. (January 2002)
From the Kaiser Family Foundation and the Commonwealth Fund:
Medicare's Disabled Beneficiaries: The Forgotten Population in the Debate over Drug Benefits was conducted to provide policymakers with better information on disabled beneficiaries' need for prescription drug coverage. The report concludes that Medicare beneficiaries with disabilities have few coverage options for prescription drugs besides Medicaid. (September 2002)
From Mathematica Policy Research Inc.:
New Medicaid Drug Use and Cost Data Highlight Issues for States after Medicare Part D examines a number of Medicaid prescription drug issues that states still need to address after the movement of dual eligibles into Medicare Part D. (June 2007)
Prescription Drug Use and Expenditures among Dually Eligible Beneficiaries in particular examines three important subgroups: the elderly, people with disabilities, and full-year nursing home residents. The analyses indicate great variation in use and expenditures across states that cannot be explained by differences in use of cost-containment strategies. (Summer 2007)
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