Drug pricing has become one of the biggest areas of concern for Americans. As both federal and state government spending on Medicaid programs has grown exponentially in recent years, states are taking action to contain drug costs in Medicaid through traditional methods like utilization management as well as through innovative methods like value-based contracts. Increasingly, states are using the flexibilities offered to Medicaid programs to reimagine the way prescription drugs are managed and study new methods of payment for the latest treatment modalities that offer meaningful clinical impact.

On February 27, 2020, Avalere experts discussed the latest policy, pricing, and reimbursement challenges in Medicaid. They reviewed the ways prescription drugs are managed in the Medicaid program, the questions states are asking, and what comes next.

Key Topics

• Medicaid prescription drug budgeting and management
• Capped funding, rebates, and alternative payment models
• Payment for new high-priced treatments that promise to cure disabling conditions
• Option for states to have closed formularies for healthy adult populations