Working Papers

Better Together? The Impact of Multi-State Purchasing Pools on Medicaid Drug Spending and Utilization, with David Powell

We study the effects of multi-state purchasing pools for Medicaid prescription drugs on drug rebates, utilization, and payment rates. These purchasing pools combine bulk purchasing with preferred drug lists to increase state bargaining power in negotiating supplemental rebates with drug manufacturers for Medicaid. Since 2003, over 30 states have participated in one of the three Medicaid-focused purchasing pools. Using data from the Medicaid Budget & Expenditure System and the State Drug Utilization Data, we find that entering a purchasing pool increases the probability of a state collecting supplemental drug rebates and the amount of these rebates. Utilization for generic drugs goes up while per-prescription payment decreases for both branded and generic drugs following a state’s participation in a purchasing pool. Our analysis suggests that both combined volume/negotiation and access to pricing information may be at play in driving these results.

 

Selected Work In Progress

Impact Evaluation of Indonesia’s Primary Health Care Accreditation Program

Impact Evaluation of an SRHR Info-line in India, with Saravana Ravindran [Fieldwork in progress]

Climate Change and Health Care, with Tong Liu

The Opioid Overdose Crisis, with David Powell, Jevay Grooms, and Rosalie Pacula

 

Dormant

Panel Survey of Medical and Nursing Students in Cambodia, with Sebastian Bauhoff and Somil Nagpal

Hospital Financial Performance Under the 340B Drug Pricing Program - a Tale of Multi-Payer System