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MEDICAID MANUAL LISTS 132 GENERICS PRICED WITHIN HHS AGGREGATE COST CEILING

Executive Summary

HHS has included 132 multiple-source prescription durgs with upper price limits for their specific dosage forms in its Medicaid Manual. States that reimburse for drugs at the listed prices will be assured of federal funding. The manual provides a list of specific therapeutically equivalent products available at prices within the ceiling established in the Medicaid final regulation, published by HHS on July 31. The rule's aggregate reimbursement cap is set at 150% of the lowest published price for multiple-source drugs ("The Pink Sheet" Aug. 3, p. 3). The department said it will update the list "periodically, possibly semi-annually." The Medicaid price ceilings for three drug products will allow reimbursement of the brandname versions, the manual notes, because "application of the 150% formula yields a federal financial participation (FFP) limit that exceeds the commonly known brandname listed price." The products are Lederle's Dolene (acetaminophen 650 mg/propoxyphene 65 mg), erythromycin ethylsuccinate (including Abbott's EES and Ross' Pediamycin) and P-D's Meclomen (meclofenamate). Chart omitted.
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