KFF October 11, 2024
Managing the Medicaid prescription drug benefit and pharmacy expenditures is a long-standing policy priority for state Medicaid programs. Prescription drugs account for approximately 6% of total Medicaid spending, and Medicaid gross and net spending on prescription drugs continues to rise, in part due to the emergence of new, high cost drugs, including anti-obesity medications and cell and gene therapies that treat, and sometimes cure, rare diseases. Under the federal Medicaid Drug Rebate Program (MDRP), states must cover nearly all FDA-approved drugs from rebating manufacturers, but most states are in the process of implementing various cost containment initiatives to combat rising pharmacy costs such as value-based purchasing arrangements and pharmacy benefit manager (PBM) reforms. There have also been various federal actions...
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