- Are you aware of the impact this could have on you as a manufacturer from a profitability perspective?
- Have you had the chance to forecast new Medicaid liabilities potentially starting in 2024 and beyond?
- Do you know what sweeping impacts could occur for every Rx written and dispensed for a Medicaid FFS/Managed Medicaid recipient?
- Did you anticipate the changes from the American Rescue Plan Act would be overturned/appealed/not implemented?
Currently, Medicaid rebates paid by drug manufacturers are capped at the quarterly Average Manufacturer’s Price (AMP) for each drug/biologic. The removal of the cap means that drugs with inflationary penalties will have a risk for revenue leakage, potentially having to pay states to use their drugs!
While manufacturers with longer patent exclusivities – may not be impacted right away, many should carefully evaluate drug pricing strategies and Medicaid calculations to determine potential changes to Medicaid rebates starting 2024.
Have you forecast your new Medicaid liabilities?
If you want to discuss strategies related to reducing liability and revenue leakage, schedule a call with Emily Phillips.
