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Comparative Study
. 2004 Spring;25(3):25-34.

Generic drug cost containment in Medicaid: lessons from five state MAC programs

Richard G Abramson  1 , Catherine A Harrington, Raad Missmar, Susan P Li, Daniel N Mendelson
Affiliations
Comparative Study

Generic drug cost containment in Medicaid: lessons from five state MAC programs

Richard G Abramson et al. Health Care Financ Rev. 2004 Spring.

Abstract

In Medicaid, generic drug cost containment revolves around two programs: the Federal upper limit (FUL) program and State maximum allowable cost (MAC) programs. This article analyzes MAC programs in five States and finds considerable variation between these programs and the FUL program in both size and pricing aggressiveness. We conclude that expansion of existing MAC programs and creation of new ones could contribute to cost containment efforts nationwide. Options for States seeking to optimize their efforts include focusing on pricing for drugs with high sales volumes, ensuring that MAC lists include prices for all forms and dosages of listed drug entities, and collaborating with other States or the Federal Government on MAC list operations.

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References

    1. Bridges S. Arkansas Medicaid, Personal communication. Little Rock, Arkansas: Oct 31, 2002.
    1. Centers for Medicare & Medicaid Services. Federal Upper Limits on Drugs. Internet address: http://cms.hhs.gov/medicaid/drugs/drug10.asp. (Accessed 2004.)
    1. Childs S. Washington Medical Assistance Administration, Telephone interview. Olympia, Washington: Jul 28, 2002.
    1. Code of Federal Regulations. Access to Services. Title 42-Public Health. Vol. 3. U.S. Government Printing Office; Washington, DC.: Oct 1, 2002. Part 42 CFR 447.333. Office of the Federal Register, National Archives and Records Administration.
    1. Code of Federal Regulations. Access to Services. Title 42-Public Health. Vol. 3. U.S. Government Printing Office; Washington, DC.: Oct 1, 2002. Part 42 CFR 447.332 (a). Office of the Federal Register, National Archives and Records Administration.

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