In-Depth Illustration of Medicaid Drug Pricing and Rebates

March 21, 2024 11:00am

Melissa Wong
Partner
Holland & Knight LLP

  • Exploring the components of Medicaid’s drug rebate system
    • Defining AMP and the AMP cap
    • What is “Best Price”?
  • Outlining the formulas needed to determine unit rebate amounts
    • Unit rebate amount for brand drugs
    • Unite rebate amount for generic drugs
  • Understanding the impact of price increases on unit rebate amounts
    • What is the baseline period for brand drugs?
    • What is the baseline period for generic drugs?
  • Identifying line extensions and their impact on unit rebate amounts
  • Dissecting manufacturer reporting requirements
    • What are the best practices?
  • Analyzing the downstream effects on AMP, Best Price, and unit rebate amounts
  • Answering how the IRA impacts Medicaid indirectly (dual-eligible)