High-Priced Drugs and Medicaid: SMART-D Releases First Report on Alternative Payment Models for Prescription Drugs Within State Medicaid Programs

Medicaid The Center for Evidence-based Policy

The Center for EvidenCEBP-Logo-4C-CMYKce-based Policy (CEbP) is making progress on SMART-D, the State Medicaid Alternative Reimbursement and Purchasing Test for High-Cost Drugs. Earlier this month, the SMART-D group released a report examining the landscape of Medicaid drug purchasing, specifically focusing on state Medicaid programs’ ability to pursue alternative payment models. The SMART-D Summary Report suggests that multiple opportunities exist to help improve patient access to evidence-based therapies while allowing states to predict and manage prescription drug costs. A new website, Smart-D.org, was also launched

“Today’s payment landscape is especially challenging for state Medicaid programs, which are struggling to balance budgets as more and more innovative treatments become available, often at a higher cost,” said Pam Curtis, director of CEbP. “This research can help achieve the triple win of maintaining access to treatments for Medicaid enrollees while also ensuring that drug manufacturers are reimbursed and states manage costs as effectively as possible.”

The Center is a strategic partner of the Milbank Memorial Fund (MMF); the two organizations collaborate on promoting the development of evidence-informed health policymaking capacity in states. MMF is assisting SMART-D with staff support, strategic counsel, and advisory-board convening. “Access to affordable prescription drugs is a key policy issue for states,” said Christopher F. Koller, president of MMF. “The SMART-D report is an authoritative overview of prescription drug programs in Medicaid and options for states to get more value for their enrollees.”

Now that Phase I of the project is complete, the SMART-D group plans to move forward with Phase II, which will involve working with several states to explore opportunities to collaborate with drug manufacturers and providing implementation and technical assistance to states.