Gross Medicaid Prescription Drug Spending
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FY 2024
Location Gross Medicaid Drug Spending
United States 103580049116 Alabama 1017318089 Alaska 193638342 Arizona 1875344452 Arkansas 462494958 California 14833143792 Colorado 1464734515 Connecticut 1898577202 Delaware 267976238 District of Colubia 281540263 Florida 3317346541 Georgia 1302197166 Hawaii 298351899 Idaho 550545595 Illinois 3120411459 Indiana 2740900036 Iowa 793967173 Kansas 348750349 Kentucky 2128939498 Louisana 2471912446 Maine 489819906 Maryland 1715921594 Massachusetts 2271621954 Michigan 3736829475 Minnesota 1053895122 Mississippi 568211697 Missouri 1814865496 Montana 375016685 Nebraska 460041876 Nevada 659886235 New Hampshire 230282586 New Jersey 1965176181 New Mexico 594375551 New York 10396952730 North Carolina 2874836789 North Dakota 96817422 Ohio 4512455758 Oklahoma 972170588 Oregon 899592386 Pennsylvania 4496213277 Rhode Island 307207720 South Carolina 696727268 South Dakota 228638340 Tenneessee 1492241864 Texas 3542175651 Utah 360696748 Vermont 179132069 Virginia 4447631065 Washington 1653475592 West Virginia 834848079 Wisconsion 1951981495 Wyoming 43194268
Notes
Gross spending is from the State Drug Utilization Data (SDUD). The SDUD are updated quarterly, which means prescription and gross spending totals can vary depending on when the data is downloaded, and totals may not match other outside sources or prior KFF analysis for this reason.
Manufacturers that want their drugs covered by Medicaid are required to rebate a portion of drug payments under the Medicaid Drug Rebate Program (MDRP), and in return, Medicaid must cover almost all FDA-approved drugs produced by those manufacturers. In addition to federal statutory rebates, most states negotiate with manufacturers for supplemental rebates.The gross spending data reported here represent Medicaid drug spending before rebates and, therefore, do not relfect states' Medicaid drug spending net of those rebates. Medicaid prescription drug rebate data are available [here](). Please note, the gross spending and rebate amounts are derived from different data sources and there may be timing differences that cause misalignment between the prescriptions paid for by Medicaid in the SDUD and the rebates reported in the CMS-64.
CMS has suppressed SDUD cells with fewer than 11 prescriptions, citing the Federal Privacy Act and the HIPAA Privacy Rule, and has excluded spending for those prescriptions from both the national and state data. However, given the larger number of prescriptions, fewer drug records are suppressed and excluded in the national data compared with the state data. As a result, the sum of the state total psending is less than and will not sum to the national total spending. Suppression in the national data is unknown, though MACPAC indicates suppression was 0.9% of gross spending in FY 2014. For more information, see methods of Recent Trends in Medicaid Outpatient Prescription Drugs and Spending .
Sources
KFF analysis of CMS-64 Financial Management Reports and State Drug Utilization Data (SDUD), accessed April 2026
Definitions
Gross Spending represents all Medicaid drug spending before rebates on covered outpatient drugs under the Medicaid Drug Rebate Program (MDRP) paid for by states and reported to CMS.