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Officials flag rising specialty drug costs, rebates and accelerated‑approval risks in Medicaid pharmacy briefing
Summary
Brendan Joyce, clinical and pharmacy services director for Medicaid, told the committee a small number of high‑cost drugs now account for a large share of prescription spending and that supplemental and mandatory rebates are critical to keeping net pharmacy costs manageable.
Brendan Joyce, clinical and pharmacy services director for Medicaid, told the Appropriations Human Resources Division that specialty and high‑cost drugs now dominate pharmacy spend and that rebates are central to managing net costs.
Joyce described several trends: a small number of drug classes and products account for a large portion of pre‑rebate spending (for example, six drug classes—cystic fibrosis, immunomodulators, migraine, non‑insulin diabetes medications, pulmonary hypertension, and tardive dyskinesia—produced a 138% increase in spend between Q1 2020 and Q3 2024 while claims volume rose only 14% for those classes). He also reported that 50 “hyper‑cost” drugs represent roughly a third of the drug…
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