Ohio's Joint Medicaid Oversight Committee may discuss the results of a long-awaited report on pharmacy drug pricing during its first meeting of the year Sept. 19, according to The Columbus Dispatch.
Dave Yost, Ohio's Attorney General, recommended in April that the state make major changes to how its pharmacy benefits are managed. Following his recommendation, the state banned pharmacy benefit managers from using spread pricing.
Spread pricing happens when a pharmacy benefit manager keeps a portion of the amount paid to them by healthcare providers instead of giving all the money to the pharmacies they manage, according to the Centers for Medicare and Medicaid Services.
Before the ban, PBMs billed the state far more than they paid pharmacists and kept the difference, giving themselves a $224 million profit in a single year, the Dispatch reported. Now, PBMs are supposed to charge the state the same price they pay pharmacists to fill prescriptions, which should save taxpayers money.
The report focuses on pricing restrictions that went into place Jan. 1 and the ban on spread pricing to determine if those policies have caused a positive change.
Some committee members doubt the effectiveness of the new policies, according to the Dispatch, because of new federal data that shows the prices of generic specialty drugs have jumped since Ohio banned spread pricing in Medicaid. The data also showed that reimbursements by CVS Caremark were still far below what the industry considers a break-even point.
Read the full article here.
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