This edition summarizes our tabulations of several key Medicaid prescription drug cost and usage trends across the 2018-2022 timeframe.  Our findings include:

• Pre-rebate costs per Medicaid prescription grew sharply, at an average annual rate of 9.7% from 2018-2022.
• Prescriptions per Medicaid enrollee have trended steadily downward since the onset of the COVID-19 pandemic.  
• Pre-rebate MCO costs per prescription were 38.2% below the corresponding fee-for-service (FFS) figure in 2018 but this differential was less than half as wide (16.6%) during 2022. 
• Managed care organizations (MCOs) paid for 74.3% of Medicaid prescriptions during Q4 2021.  This proportion dropped to 62.5% in Q4 2022, with the decrease largely attributable to California implementing a carve-out model in January 2022.