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Tag: Prescription Drugs

Trends in Medicaid’s Average Costs Per Prescription

This edition presents our tabulations of Medicaid pharmacy cost and price trends. Some of our key findings: Nationwide Medicaid pre-rebate costs per prescription increased at an annual average rate of 5.6% from 2012-2021, led by an 11.9% annual rate of…

Jun. 21, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Pharmacy Usage During COVID

This edition quantifies the decrease in Medicaid prescription volume that has occurred during COVID, comparing usage during calendar years 2019, 2020, and 2021. The large decrease that has occurred – 16.4% from 2019 to 2021 on a per covered person…

May. 30, 2022 Download 5 slide

KEYWORDS:COVID-19, Medicaid, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

We were enlisted by the Anthem Public Policy Institute to assess the cost-effectiveness of different states’ approaches to managing Medicaid prescription drug benefit. States were grouped into five cohorts depending on the degree to which their Medicaid prescriptions are paid…

Apr. 1, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

States that employ Medicaid managed care organizations (MCOs) to pay for prescription drugs outperform states that rely on the fee-for-service (FFS) setting to control drug costs. Despite larger rebates in FFS, MCOs’ effective strategies to encourage...

Mar. 1, 2022 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Assessment of New Jersey’s Medicaid Prescription Drug Management Performance and Policy Options

The New Jersey Association of Health Plans enlisted the Menges Group to evaluate New Jersey’s Medicaid prescription drug costs and assess the potential impacts of a pharmacy carve-out approach, whereby the prescription drug benefit would be removed from the MCOs’…

Feb. 16, 2021 Download Full Report

KEYWORDS:Pharmacy Carve Out, Policy, Prescription Drugs

Assessment of Common Core Formulary Impacts on Virginia Medicaid Managed Care Drug Spending

Virginia began implementing a Common Core Formulary within its Medicaid managed care program in 2017 for CCC Plus members and in 2018 for Medallion 4.0 members. The Virginia Association of Health Plans (VAHP) engaged The Menges Group to analyze the…

Jan. 14, 2020 Download Full Report

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Value of Managed Care Organizations and Pharmacy Benefit Managers in Managing the Medicaid Prescription Drug Benefit

PCMA engaged The Menges Group to estimate the financial and programmatic value of managing the prescription drug benefit in the Medicaid managed care setting, comparing states that utilize MCOs – who contract with PBMs – for their prescription drug benefits…

Oct. 1, 2019 Download Full Report

KEYWORDS:Medicaid, Prescription Drugs

Assessment of Pennsylvania’s Medicaid Preferred Drug List Policy Options

The Pennsylvania Coalition of Medical Assistance MCOs engaged The Menges Group to estimate the fiscal impacts of switching to a uniform PDL in Pennsylvania and to assess the programmatic advantages and disadvantages of this policy change. Our analyses indicate that…

May. 7, 2019 Download Full Report

KEYWORDS:Policy, Prescription Drugs

Assessment of Report on Impacts of West Virginia Medicaid Prescription Drug Carve-Out

America’s Health Insurance Plans (AHIP) engaged The Menges Group to assess West Virginia’s Medicaid pharmacy carve-out impacts, analyzing the findings of another consulting firm’s report. Our analyses suggest that West Virginia’s carve-out has created increased Medicaid expenditures rather than savings.…

Apr. 1, 2019 Download Full Report

KEYWORDS:Medicaid, Pharmacy Carve Out, Prescription Drugs

An Analysis of Medicare Part D and Medicaid Prescription Drugs

This month’s edition analyzes and compares prescription volume and drug costs in the Medicaid and Medicare Part D programs. We tabulated pre-rebate cost per prescription for each program from 2013-2017. We also analyzed trends in specialty drug volume and expenditures…

Mar. 1, 2019 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Medicare, Prescription Drugs