STAT+: Pharmalittle: Biden administration proposes yearly audit for costliest Medicaid drugs; few at high risk of HIV take prevention pills
The administration is planning a yearly audit to verify prices drugmakers charge on a handful of the costliest prescriptions covered by Medicaid.
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The Biden administration is planning to conduct a yearly audit to verify the prices drugmakers charge on a handful of the costliest prescriptions covered by Medicaid, the Associated Press explains. Under the proposal, the U.S. Centers for Medicare and Medicaid Services would require as many as 10 drugmakers every year to furnish the government with proprietary and non-proprietary information as evidence to support the price it charges states, which administer Medicaid. Drugs that cost Medicaid the most money — some as much as $2 million per treatment — will be selected for the survey.
Under an upcoming rule proposed by the Biden administration, pharmacy benefit managers that contract with Medicaid would have to reveal the prices they pay for medicines, Modern Healthcare writes. The move seeks to curb spread pricing, a practice in which pharmacy benefit managers charge insurance companies, employers, or government programs more for medicines than they actually pay. If finalized, this would be the first time that pharmacy benefit managers are required to disclose actual drug prices under federal law. The regulation also would make specialty drugs administered in hospitals eligible for rebates.
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