Filling the need for trusted information on national health issues

How Does the Trump Administration Drug Pricing Blueprint Affect Medicaid?

Issue Brief
  1. “Public Opinion on Prescription Drugs and Their Prices,” Kaiser Family Foundation, https://www.kff.org/slideshow/public-opinion-on-prescription-drugs-and-their-prices/.

    ← Return to text

  2. K Young and R Garfield, Snapshots of Recent State Initiatives in Medicaid Prescription Drug Cost Control, Kaiser Family Foundation, February 2018, https://www.kff.org/medicaid/issue-brief/snapshots-of-recent-state-initiatives-in-medicaid-prescription-drug-cost-control/.

    ← Return to text

  3. Secretary Azar presented this position in his comments at the White House Press Briefing Friday, May 11th, 2018.

    ← Return to text

  4. 42 U.S.C. 1396r-8(c)

    ← Return to text

  5. FY 2019 HHS Budget in Brief, “Putting America’s Health First, FY 2019 President’s Budget for HHS,” https://www.hhs.gov/sites/default/files/fy-2019-budget-in-brief.pdf.

    ← Return to text

  6. In August 2017, Mylan settled with the Department of Justice to resolve claims that they had intentionally classified the EpiPen product incorrectly as a generic drug to pay less money in rebates to Medicaid. See “Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates,” Department of Justice, August 17, 2017, https://www.justice.gov/opa/pr/mylan-agrees-pay-465-million-resolve-false-claims-act-liability-underpaying-epipen-rebates. Additionally, a 2017 OIG report found that Medicaid lost over a billion dollars in rebates between 2012 and 2016 due to misclassification of drugs. See “Potential Misclassifications Reported by Drug Manufacturers May Have Led to $1 Billion in Lost Medicaid Rebates,” HHS, Office of Inspector General, December 2017, https://oig.hhs.gov/oei/reports/oei-03-17-00100.pdf.

    ← Return to text

  7. For more information on formularies in Medicaid, see Young and Garfield, op. cit.

    ← Return to text

  8. The Blueprint strongly favors value-based pricing, at one point saying “[v]alue-based transformation of our entire healthcare system is a top HHS priority.”  Value-based pricing is a popular idea, and one that requires reconciling with the best price aspect of the MDRP.

    ← Return to text

  9. On May 15th 2018, CMS unveiled its “enhanced drug dashboard.”

    ← Return to text