State budgets continue to absorb significant cost increases related to pharmaceuticals, and the Kansas Medicaid program (KanCare) — at 16.7 percent of state general funds — is under the microscope for issues related to drug payments and discount reporting by pharmacy benefit managers (PBMs).
On February 17, 2022, the Kansas Health Institute (KHI) hosted a virtual discussion and provided a brief overview of Medicaid pharmacy pricing, high-cost drugs, rebates and PBMs, along with a discussion of state policy options for controlling cost. Phillip Steiner, M.A., led the discussion.
KHI materials related to this topic are linked below:
- Slides from the Presentation: The Cost of Care: Prescription Drugs in KanCare (February 2022)
- Report: Kansas Medicaid: A Primer 2022 (January 2022)
- Issue Brief: Prescriptions for Change: The Price of Drugs and State Cost Control Strategies (June 2020)
External resources referenced in the discussion include:
- Kaiser Family Foundation (KFF): States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2021 and 2022 (October 2021)
- Medicaid and CHIP Payment and Access Commission (MACPAC): Addressing High-Cost Specialty Drugs (June 2021)
- Ohio Medicaid Managed Care: Ohio Medicaid Single Pharmacy Benefit Manager (SPBM) (n.d.)
- Arnold Ventures: New Poll: Majority of Voters Want Congress To Take Action To Lower Health Care Prices (June 2021)
- KFF: Pricing and Payment for Medicaid Prescription Drugs (January 2020)
- Health Affairs: The Contribution Of New Product Entry Versus Existing Product Inflation In The Rising Costs Of Drugs (January 2019)
A recording of the session is below. To view specific topics from the agenda, move the slider to the time listed.
- Introduction (0:00 on the recording)
- Agenda (3:25 on the recording)
- Poll: Factors Driving up the Cost of Health Care (4:07 on the recording)
- KanCare MCO Spending by Category of Service (6:38 on the recording)
- Discussion (15:04 on the recording)
- KanCare Pharmacy Benefit (16:56 on the recording)
- Medicaid Drug Pricing (20:03 on the recording)
- Specialty and High-Cost Drugs (25:13 on the recording)
- Discussion (27:43 on the recording)
- National RX Spending Trends (32:52 on the recording)
- Discussion (37:08 on the recording)
- State Medicaid Policy (43:59 on the recording)
The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.