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Medicaid Outpatient Prescription Drugs: Estimated 2007 Federal Upper Limits for Reimbursement Compared with Retail Pharmacy Acquisition Costs
John E. Dicken (au)
Spending on outpatient prescription drugs (PD) in Medicaid has accounted for a substantial & growing share of Medicaid expend. This report provides info. on how the average manufacturer price (AMP)-based fed. upper limits (FULs) compare with retail pharmacy acquisition costs. Dicken estimated what the AMP-based FULs would have been if they had applied in 2006 & compared them with average retail pharmacy acquisition costs from 2006 for frequently used & high expend. multiple-source outpatient PD in Medicaid. For the sample of 77 multiple-source outpatient PD, Dicken found that these estimated AMP-based FULs were, on average, 36% lower than average retail pharmacy acquisition costs for the first quarter of 2006. Charts & tables.
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