Medicaid’s Most Costly Outpatient Drugs

(By Katherine Young, Robin Rudowitz, Rachel Garfield, and Marybeth Musumeci for Kaiser Family Foundation)

The launch of several expensive hepatitis C drugs over the past few years has ushered the topic of high cost prescription drugs back into the public’s and policymakers’ attention. With over 70 million beneficiaries, many of whom have complicated health needs, Medicaid is one of the largest providers of prescription drugs in the United States. State Medicaid agencies have a variety of mechanisms to help control outpatient drug spending that they have been using widely for the past decade. However, new prescription drugs are always coming to market, and the health needs of the Medicaid population change over time, especially as enrollment grows because of ACA Medicaid expansion. As a result, it is helpful for policy makers to understand which drugs used by the Medicaid program are most expensive. In this issue brief, we determine the 50 most costly drugs before rebates used by the Medicaid program from January 2014 through June 2015. We then examine reasons why these drugs are so costly, as well as exploring case studies on opioids, hepatitis C drugs, and the drug Abilify. Key findings include the following: Read article here……

Kaiser Health News is a nonprofit national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.


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