Prescription Drugs & Other Medical Products

The United States relies on the interactions of private entities – drug manufacturers, health plans and pharmaceutical benefit managers (PBMs) - to achieve value by negotiating prices, operating formularies and implementing other benefit management strategies. The U.S. does not establish or negotiate prices for prescription drugs, as do some other countries. A critical part of the U.S.

Trends in Hospital Readmission and Emergency Department Visit among Infants Born with Neonatal Abstinence Syndrome ASPE ISSUE BRIEF Mir M. Ali, Emma Nye, and Kristina West U.S. Department of Health and Human Services

Use of Outpatient Pharmacological Treatment Among Infants Born with Neonatal Abstinence Syndrome: Medicaid 2008-2017 ASPE ISSUE BRIEF Mir M. Ali, Emma Nye, and Kristina West U.S. Department of Health and Human Services

Buprenorphine treatment has been found to be an effective treatment for opioid use disorder (OUD). Child welfare systems have been partnering with treatment providers to increase access, yet little is known about its role in improving outcomes related to child maltreatment.

How Does DATA-Waiver Provider Patient Capacity Relate to Opioid and Buprenorphine Prescribing? Issue Brief Robin Ghertner and Mir M. Ali U.S. Department of Health and Human Services

Postpartum Opioid Prescription Fills, Opioid Use Disorder, and Utilization of Medication-Assisted Treatment among Women with Medicaid and Private Health Insurance Coverage Issue Brief Mir M. Ali, Kristina West, and Emma Nye U.S. Department of Health and Human Services

Medicare covers prescription drugs provided during inpatient hospital and skilled nursing facility stays through Part A, retail prescription drugs through Part D, and drugs provided in physicians’ offices and hospital outpatient departments through Part B. Over the 2006-17 period, Medicare FFS Part B drugs spending per enrollee grew at 8.1 percent annually.

The September 13, 2020 Executive Order on Lowering Drug Prices by Putting America First declared, “It is the policy of the United States that the Medicare program should not pay more for costly Part B or Part D prescription drugs or biological products than the most-favored-nation price.” The Most Favored Nation (MFN) Model issued by the Centers for Medicare & Medicaid Services (CMS) on No

Insulin prices have increased dramatically over the past decade in the United States. This report presents results from international price comparisons of insulins using a price index approach.

Treatment providers, policymakers, and others are seeking ways to reverse the tide of mortality and morbidity that has accompanied the opioid epidemic. There are evidence-based treatments for opioid use disorder (OUD), including medication-assisted treatment (MAT) using buprenorphine, methadone, and naltrexone. Research shows that retention in MAT results in better outcomes.