MedCost Cover.

The UB Medication Cost and Value team promotes effective utilization of NYS Medicaid resources by advising the Department of Health (DOH) on the management of high-cost drugs. UB clinical pharmacists and data analysts collaborate with partners at DOH to complete in-depth, evidence-based reviews of selected products, incorporating a wide range of clinical and pharmacoeconomic considerations.

Medicaid Drug Cap

To protect New Yorkers from increasing prescription drug costs, 2018 legislation established a cap on the growth of prescription drug spending in the Medicaid program.  When that cap is exceeded, Public Health Law §280 authorizes the NYS DOH to negotiate for supplemental rebates on pharmaceuticals with the greatest impact on spending growth. UB’s Medication Cost and Value team supports negotiations and DOH assessment of selected drugs via the following services:

  • Clinical review
  • Pharmacoeconomic evaluation
  • Utilization analysis
  • Development of recommendations for action
  • Presentation of findings to the NYS Drug Utilization Review Board

Past Drug Cap topics presented to the board include:

More information is available in the General Medicaid Drug Cap FAQs.