Specialty drug prices squeeze Virginia’s Medicaid program: 5 key notes

The state of Virginia’s Medicaid program is feeling the burden of the high specialty prescription costs, the Daily Press reports.

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Here’s what you should know.

1. With costs for Medicaid’s “fee-for-service” program rising more than 14 percent to $12,938 per recipient year-over-year, the state’s Department of Medical Assistance Services believes more increases are coming.

2. The department’s pharmacy manager Donna Proffitt told the Daily Press she believes specialty drugs will soon take up more than 50 percent of the total amount spent on drugs.

3. In 2015, Medicaid spent $37.8 million or under 8 percent on specialty drugs. That $37.8 million was for only 1,625 Medicaid beneficiaries.

4. Hepatitis C drugs make up the majority of the increased spending in Virginia.

5. The high cost of these specialty drugs sparked a debate in the state’s general assembly after the tabling of a bill increasing cost transparency.

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