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Medi-Cal

Executive Summary

Ulcer treatment is the first category in which California Medicaid will implement its new program to limit the number of single-source products for coverage. Seven ulcer drugs are now covered; the state hopes to designate a more limited list by Christmas. The state's recent budget rescue package included first-year savings of $18 mil. from the selective coverage effort but did not include an earlier requirement that only one preferred drug be selected in a therapeutic category ("The Pink Sheet" Nov. 7, p. 4). Medi-Cal has also now signed up 140 companies that agree to meet "supplemental" rebate requirements, including at least 30 that had previously had direct rebate contracts with the state. The budget plan directed that companies must provide a net rebate of 25% for single-source products or else the products are available only by prior authorization. Manufacturers must provide a 15% rebate for generics.

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