Abstract
In the absence of notable action by the US Congress to address rising prescription drug prices, many states have moved to fill the gap.1 State Medicaid programs, which finance 10% of outpatient prescription drug spending, have recently adopted innovative approaches to paying for prescription drugs.
Highlights
In the absence of notable action by the US Congress to address rising prescription drug prices, many states have moved to fill the gap.[1]
Direct-acting antivirals for hepatitis C virus (HCV) are considerably more effective than existing therapies, but they come with extraordinarily high prices—up to $95 000 per treatment course.[4]
The burden of these high prices falls disproportionately on Medicaid, which covers a large share of individuals with HCV
Summary
Medicaid rebates are substantial, reducing gross Medicaid drug spending (based on list prices) by more than 50% in 2017.2 The program has prevented states from establishing restrictive formularies, states may impose other cost-containment measures, such as caps on the number of prescriptions.[3] The introduction of medications to treat hepatitis C virus (HCV) exposed the limits of the Medicaid rebate program for balancing the goals of cost containment and adequate access to effective medications. In this issue of JAMA Health Forum, Auty et al[5,6] examine 2 approaches that state Medicaid programs have taken to address the high costs of HCV medications while ensuring access.
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