Major Medicaid Drug Payment Rule Under OMB Review: Last week a highly anticipated rule that could set the standards for the Medicaid Drug Rebate program arrived at the White House for final review. The Medicaid Outpatient Drug Rule could include significant changes to what is included (and what is not) in the Average Manufacturer Price (AMP) calculation and how “best price” would be calculated for rebate purposes versus strictly discounts. Stakeholders beyond drug manufacturers that have engaged policymakers on this upcoming rule range from Pharmacy Benefit Managers (PBMs) to chain pharmacies and even insurance carriers, among others.

Lawmakers in Congress have also expressed an interest in modifying the AMP calculations for the Medicaid program such as the recent 21st Century Cures Act that was passed in the House. That legislation would have excluded generics from the AMP calculation.