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Medicaid Managed Care Drug Rebates Saved States, Feds $1.6 Billion in First Year
Date:9/12/2012

WASHINGTON, Sept. 12, 2012 /PRNewswire-USNewswire/ -- The Department of Health and Human Services Office of Inspector General (OIG) on Monday released a new report "States' Collection of Rebates for Drugs Paid through Medicaid Managed Care Organizations," which showed that 12 of the 22 States using a carve-in approach invoiced manufacturers and collected $1.6 billion in rebates for utilization in the second quarter of 2010 through the second quarter of 2011. The OIG surveyed states on the data collected from managed care organizations on pharmacy utilization and rebate submission to manufacturers during this period, the first five quarters for which statutory rebates on managed care pharmacy were available to states.

"One of the hallmarks of Medicaid managed care is more efficient delivery of care, including lifesaving pharmaceuticals," said Thomas Johnson, president and CEO of Medicaid Health Plans of America.  "The Medicaid managed care pharmacy carve-in model, in which prescription drugs are included in health plans' payments, encourages the use of chain drugstores and mail-order because they are more cost-efficient.  Medicaid health plans have higher generic medication dispensing rates than traditional fee-for-service Medicaid for the same reason.  Medicaid health plans are changing the way patients receive those medicines so that limited resources are spent wisely. The savings documented in this report are evidence that the model is working and working well," continued Johnson.

The pharmacy carve-in also increases the efficiency of healthcare delivery by allowing plans to coordinate pharmacy benefits with medical benefits, ensuring that patients get the medicines that are right for them. Medicaid health plans ensure that pharmacy benefits are optimally managed, which includes monitoring for harmful drug interactions, improving patient adherence and compliance,
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SOURCE Medicaid Health Plans of America
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