Medicaid

Exploring Prescription Discount Cards’ Role in Medication Adherence

December 4, 2023 - Since prescription discount cards were introduced into the United States market in the early 2000s, patients and providers have leveraged them to combat rising drug costs and make medications more affordable. By enhancing drug affordability, prescription discount cards can improve medication adherence among underinsured patients, providing a more cost-effective option. According to an...

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HHS and Pfizer Reach Paxlovid Agreement to Improve Access

by Veronica Salib

Last week, the United States Department of Health and Human Services (HHS) announced that it had negotiated an agreement with Pfizer Inc. to bolster access to Paxlovid as it enters the commercial...

Understanding the Burdens of Dialysis

by Veronica Salib

Chronic kidney disease (CKD) occurs when the kidneys fail to filter waste as they typically do in a healthy body. Patients in the late stage of chronic kidney disease progress to end-stage renal failure (ESRF) when they need a transplant...

Patient, Prescription-Related Factors Linked to Opioid Overdose

by Samantha McGrail

Patient factors, including Medicaid or Medicare Advantage, comorbid substance use disorder, medical comorbidities, and prescription-related factors, are associated with opioid overdose, according to a...

Specialty Drugs Accounted for Half of Medicaid Spending in 2020

by Samantha McGrail

Specialty drugs accounted for 51.4 percent of the net cost in Medicaid and 1.3 percent of utilization in 2020, according to a Magellan Health trend report. The Medicaid Pharmacy Trend Report looked at...

CMS Proposes Delay of Medicaid Value-Based Payment Requirements

by Samantha McGrail

CMS recently proposed delaying Medicaid value-based drug payment requirements for state purchasing agreements with drug manufacturers until July 2022.  The rule, called “Medicaid Program...

CMS Rule Allows Payers to Negotiate Prescription Drug Pricing

by Jessica Kent

CMS has issued a final rule allowing payers to negotiate prescription drug pricing based on how well these drugs work for patients, a policy that could reduce overall healthcare spending and...

US Spending on Specialty Drugs Increases Year Over Year

by Samantha McGrail

Specialty drugs accounted for 37.7 percent of retail and mail order prescription spending net of rebates in 2016-2017, a recent Health Affairs study found. Researchers leveraged nationally...

Invoice-Based Drug Reimbursement Did Not Cut Medicaid Spending

by Samantha McGrail

In states that switched to drug reimbursement models where results were based on a survey of pharmacy invoices, researchers found no effect on overall Medicaid outpatient drug spending, according to a...

Delayed Generic Drug Entry Cost Medicaid $761M, Study Finds

by Samantha McGrail

Medicaid spent an estimated $761 million in excess costs over seven years due to delayed generic drug entry costs, according to a recent study.   Delayed generic drug entry is common,...

Court Tells Mallinckrodt to Pay $650M in Back Medicaid Rebates

by Samantha McGrail

Global pharmaceutical company Mallinckrodt recently announced that the US District Court for the District of Columbia upheld CMS’ decision over Medicaid rebates for the company’s...

Organizations Demand Clinical Trial Coverage for Medicaid Patients

by Samantha McGrail

A broad coalition is calling for Congress to ensure Medicaid patients receive access to potentially life-saving clinical trials, according to a recent letter to Congressional leaders. Last week, 106...

GAO Flags Lack of 340B Drug Discount Program Oversight

by Ana Mulero

Weakness in the oversight of the 340B Drug Discount Program allowed some hospitals to get discounted drugs they were ineligible for, a Government Accountability Office analysis found.  Hospitals,...

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