States are thinking more creatively about how to enable populations that are ineligible for Medicaid to purchase drugs at the same reduced prices negotiated by Medicaid.
- Discount Programs: Maine Rx negotiates with drug companies to provide more affordable drugs to residents living below 350% of the poverty line. The program, as NLARx reports, uses the leverage of the state's Medicaid program to achieve average savings of 25-50% on generic and brand name drugs for residents not eligible for Medicaid.
- 340B Pricing: Under federal law, certain "safety-net" programs and providers can purchase prescriptions at significant discounts, often below what Medicaid pays for drugs. States can ensure that populations and programs eligible for 340B pricing are receiving the reduced prices. Legislation in Massachusetts (H 2243) would require eligible health care centers to participate in 340B pricing, and Vermont's comprehensive prescription reform act of 2007 requires the state to inform residents of the availability of 340B pricing.
Resources:PBMs Transparency and Fiduciary Standards