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Medicare Part D Causes Big Drop in Medicaid Pharmacy Payments

Total payments to pharmacies by Medicaid fell by nearly 50%, from $38.5 billion in 2005 to $20.9 billion in 2006, according to an article in Health Affairs co-authored by the National Association of Chain Drug Stores’ senior economist Laura Miller.

ALEXANDRIA, Va. — Total payments to pharmacies by Medicaid fell by nearly 50%, from $38.5 billion in 2005 to $20.9 billion in 2006, according to an article in Health Affairs co-authored by the National Association of Chain Drug Stores’ senior economist Laura Miller. The article is also based on a study conducted by Miller and Brian Bruen, former policy staff member of NACDS who is now at Avalere Health in Washington. The study also found that the number of Medicaid-paid prescriptions dropped 49% — from 543 million to 278 million. The figures are a direct result of the shift of coverage for prescription drugs from Medicaid to Medicare. Before Medicare Part D went into effect, state Medicaid programs accounted for nearly one-fifth of U.S. prescription drug spending, and coverage for dual eligibles was about half of all Medicaid prescription drug spending. Generic dispensing rates in Medicaid programs increased dramatically, 4.6% nationally, from 2005 to 2006.

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