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Nevada Medicaid pushes single preferred drug list and rebate strategy in budget amendment
Summary
Medicaid leaders told the subcommittee they plan to implement a single preferred drug list and other pharmacy purchasing strategies to maximize rebates and fund workforce and program needs; budget materials include staff and vendor funding to begin the work.
Nevada Medicaid representatives told lawmakers they plan to implement a single preferred drug list (PDL) and other centralized pharmacy purchasing strategies to capture larger manufacturer rebates and reduce drug spending growth.
Stacy Weeks, Nevada Medicaid, told the panel the budget includes funds for pharmacy staff and a vendor to model purchasing options and to stand up a single PDL across Medicaid and other state coverage programs. "The first phase of getting to where we need to be as a state's single preferred drug list is ensuring all of our drug lists are aligned across our products," she said.
Weeks and other DHHS officials said expected rebate revenue from a consolidated PDL is part of the department's $130.7 million Medicaid amendment. The department proposes to use a portion of the additional rebate revenue to support graduate medical education (GME) and workforce incentives through targeted reimbursement adjustments.
Medicaid told the subcommittee that pharmacy costs are a top pressure in the budget and that a consolidated PDL can reduce administrative burden and the number of disruptions patients face when they move between managed care and fee-for-service programs. The department also flagged the coming wave of expensive new drug classes as a driver of pharmacy growth.
Lawmakers asked for more modeling and implementation detail, including how anticipated rebate gains were calculated and how Medicaid would manage utilization and patient continuity if a single PDL requires prior authorization or step therapy changes. Medicaid officials said they plan to procure a vendor to model options and return with a recommended approach for the Legislature.
Ending: Medicaid asked the subcommittee for conditional approval of staff and vendor funding to begin the PDL work and promised to provide financial models and a timeline for vendor selection and implementation.
