Skip to main content
NORC at the University Chicago

Medicaid Drug Price Transparency & Access Learning Collaborative

A man handing a prescription to a pharmacists
Helping Medicaid state agencies identify cost-containment strategies for prescription drugs
  • Client
    Center for Medicaid and CHIP Services, Centers for Medicare and Medicaid Services (CMS)
  • Dates
    2022 – 2024

Problem

State Medicaid agencies struggle to pay for new, high-cost drugs and therapies.

An increasing number of new, high-cost prescription drugs and therapies—including specialty drugs and cell and gene therapies—are entering the market. The federal Medicaid Drug Rebate Program (MDRP) mandates that states must cover nearly all FDA-approved drugs, including some new, high-cost therapies such as anti-obesity medications, making it difficult for state Medicaid agencies to afford many of them.

State Medicaid agencies need strategies for making new medications and therapies available to their enrollees while containing costs.

Solution

NORC helped connect states with subject matter experts to explore cost-containment strategies.

In partnership with Deloitte, NORC facilitated the Medicaid Drug Price Transparency and Access Learning Collaborative (MDPTA-LC), an engaged group comprised of state Medicaid officials, CMS leadership, and subject matter experts. The collaborative supported virtual peer-to-peer learning, led informative and interactive webinars, and conducted original research on prescription drug cost containment.  

As the project’s technical advice and support lead, NORC provided customized one-on-one support to states requesting guidance. We also contributed to the development of MDPTA-LC webinars and materials and produced quarterly and ad-hoc events to engage all levels of state Medicaid staff.  

Result

States gained strategies to support Medicaid pharmacy policy and access goals.

With NORC’s help, MDPTA-LC’s quarterly and ad-hoc events engaged state Medicaid staff—including Medicaid Directors of Pharmacy— and increased the awareness, understanding, and discussion of various cost-containment options and strategies. Those discussions covered a wide range of topics including: 

  • Value-based purchasing and outcomes-based arrangements with drug or therapy manufacturers

  • Managed care and carving in or out of pharmacy benefits

  • Prescription drug affordability boards

  • The specialty drug pipeline

  • Pharmacy benefit managers  

  • Physician-administered drugs 

  • Medicaid coverage of pharmacotherapies for obesity

  • Supporting pharmacies through disasters

These strategies will support states to continue making new medications and therapies available to their enrollees while containing costs.

Project Leads

“This learning collaborative served as a valuable gathering place for state Medicaid pharmacy professionals to learn from both the experts and each other.”

Lisa R. Shugarman

Project Director

“This learning collaborative served as a valuable gathering place for state Medicaid pharmacy professionals to learn from both the experts and each other.”

Explore NORC Health Projects

2023 & 2025 Colorado Health Access Survey

Measuring Coloradoans’ insurance coverage and access to and use of health care

Client:

Colorado Health Institute (CHI)

ACA Public Comment Review and Management (2024 & 2025)

Categorizing, analyzing, and synthesizing public comments on Affordable Care Act rulemaking

Client:

Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS)

Adapting and Implementing a Toolkit to Identify Pneumonia in Patients

Adapting and implementing patient safety practices in ambulatory care

Client:

Agency for Healthcare Research and Quality
Health Projects