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In another bid to attack high prescription drug costs, the Centers for Medicare and Medicaid Services released guidance this week to help states monitor so-called spread pricing that can unnecessarily increase what health care programs are paying for medicines.

Despite the arcane-sounding name, spread pricing is an important, behind-the-scenes issue in the opaque pharmaceutical world. Basically, this refers to what pharmacy benefit managers pay pharmacies for medicines and then bill back to state Medicaid programs. Recently, though, a growing number of states are trying to clamp down on the practice after concerns surfaced about overcharging.

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  • Ed, MONITORING ? really ? The health plan is going to monitor the PBM ? ha !! Yes Aetna is going to monitor CVS/CAREMARK ? Which they just so happen to own ! Or Cigna is going to monitor Express Scripts? Ha Ha !!!! Do the fed’s not get who they are dealing with ? Again, we have the wolf watching the
    hen house and licking his chops. Spread pricing must be done away with !!! As long as there is no sevier penalty for fleecing the state and federal government they’re gonna conduct their Maffia operations…
    business as usual !!!

  • So they’re gonna do away with spread pricing and not reform pharmacy DIR fees ? I wonder how many politicians got paid off by the deep pockets of PCMA to allow this to happen? Have no fear Ed, the PBM’s have a shit load of lawyers that will figure out another loophole around this one too.

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