Themes from Expert Roundtable on Medicaid Policy on High-Cost Drugs

In November 2019, MACPAC convened an expert roundtable to examine issues related to Medicaid coverage of high-cost specialty drugs. Participants included federal and state officials, legal and drug payment experts, Medicaid managed care organizations, drug manufacturers, patient advocates, and providers. They discussed challenges facing states in managing spending for high-cost drugs under the Medicaid Drug Rebate Program and whether different models for coverage, payment, or rebates could better address these challenges. This presentation provides an overview of specialty drug spending in Medicaid, summarizes the themes of the roundtable discussion, and discusses areas for potential Commission work.