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Tag: Prescription Drugs

Assessment of Medicaid MCO Preferred Drug Policy Options in Louisiana

Over 90 percent of Louisiana’s Medicaid prescriptions are paid for by MCOs. The Louisiana Association of Health Plans engaged us to assess the impacts of a potential policy change to take the preferred drug list (PDL) content responsibility away from…

Apr. 5, 2016 Download Full Report

KEYWORDS:Medicaid, Policy, Prescription Drugs

Share of Prescriptions by State and Major Payer

The February report pieces together different data on prescription volume by state – mostly through our staff’s tabulations – showing the distribution of each state’s total 2015 prescriptions between those paid by Medicaid, Medicare Part D, and all other payer…

Feb. 2, 2016 Download 5 slide

KEYWORDS:Medicaid, Medicare, Prescription Drugs

Assessment of Medicaid MCO Preferred Drug List Management Impacts (Texas)

The Texas Association of Health Plans engaged The Menges Group to prepare an analysis of the impacts of switching from a statewide uniform Medicaid prescription formulary to a model that allows Medicaid MCOs flexibility to develop their own preferred drug…

Feb. 1, 2016 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Medicaid, Prescription Drugs

Medicaid Pharmacy Costs and Usage Trends

This edition provides data on Medicaid prescription drug usage and costs and trends from 2013 to 2015. Each data table shows national totals and subtotals for three groups of states: non-expansion states, initial Medicaid expansion states (those implementing Medicaid expansion…

Jan. 1, 2016 Download 5 slide

KEYWORDS:Expansion, Expenditures, Medicaid, Prescription Drugs

Progression of Medicaid Costs and Usage of Selected Hepatitis C Medications: Sovaldi, Harvoni, and ViekiraPak

For the November edition of the Five Slide Series we tabluated the costs and usage of three prevalent Hepatitis C medications - Sovaldi, Harvoni, and Viekira Pak. These drugs have all been introduced within the last 2 years and have…

Nov. 1, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Cost Per Prescription Differences Between States

We tabulated the cost per prescription for FFY 2014 using a 100% sample of Medicaid-paid prescriptions in each state. Medicaid's national average net (post-rebate) cost per prescription was $37 in 2014. Initial (pre-rebate) payments to pharmacies averaged $72 per prescription;…

Jul. 24, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Pharmacy Carve-In and Carve-Out Dynamics

The June 2015 edition summarizes a full report we prepared in April, sponsored by America's Health Insurance Plans. We believe this report, "Comparison of Medicaid Pharmacy Costs and Usage in Carve-In Versus Carve-Out States," compellingly demonstrates the cost-effectiveness of using…

Jun. 16, 2015 Download 5 slide

KEYWORDS:Medicaid, Pharmacy Carve Out, Prescription Drugs

Specialty Pharmacy’s Growing Role in Medicaid

The May 2015 edition portrays the distribution of all Medicaid prescriptions by their unit cost corridor. These slides quantify the rapid growth in Medicaid prescriptions with a cost per prescription above $1,000. The high-cost medications in this corridor represented 1.3%…

May. 29, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Data on Sovaldi, Harvoni and Kalydeco

The April 2015 edition presents recent nationwide and state-level data on Sovalidi usage. These slides also convey recent usage of a related Hepatitis C medication (Harvoni) as well as a specialty pharmacy drug, Kalydeco, in a completely different clinical area…

Apr. 30, 2015 Download 5 slide

KEYWORDS:Medicaid, Prescription Drugs

Comparison of Medicaid Pharmacy Costs and Usage in Carve-In Versus Carve-Out States

This study examined 35 states and DC that used the Managed Care Organization (MCO) model in their Medicaid program and either included (carved-in) or excluded (carved-out) pharmacy benefits from coverage. The report found that carve-in states outperform carve-out states by…

Apr. 16, 2015 Download Full Report

KEYWORDS:Medicaid, Pharmacy Carve Out, Policy, Prescription Drugs