This issue brief outlines the Medi-Cal outpatient drug benefit program, summarizes the impact of Medicare Part D on drug utilization and spending by Medi-Cal enrollees, and considers Medi-Cal's approaches to managing drug costs.
The Medi-Cal Prescription Drug Benefit: An Overview (700 K)
Medi–Cal spent an estimated $4.4 billion on outpatient prescription drugs in 2007: $3.2 billion in fee-for-service (FFS) expenditures and $1.2 billion in drug coverage payments to managed care plans. In 2006, the new Medicare Part D program dramatically lowered Medi-Cal's outpatient prescription drug expenditures, but drug spending for Medi-Cal beneficiaries not enrolled in Part D continues to rise rapidly.
This issue brief provides an overview of the Medi-Cal outpatient prescription drug benefit program, summarizes the impact of Medicare Part D on FFS drug utilization and spending for Medi-Cal's nearly 2 million FFS beneficiaries, and considers Medi-Cal's approaches to managing drug costs, with particular attention to FFS utilization and spending from 2004 to 2007. The brief concludes with a discussion of issues to consider regarding the future of the Medi-Cal prescription drug program.
Key findings include:
The complete issue brief is available under Document Downloads.