CMS continues to hint at guidance on best price

In its final rule on Medicaid Covered Outpatient Drugs, the Centers for Medicare & Medicaid Services continued to suggest that it is considering guidance on how to calculate Medicaid best price under new value-based pricing models.

Medicaid best price requires manufacturers to provide drugs to state Medicaid agencies at either the lowest price offered to commercial insurers or a 23% discount from the average manufacturers price (AMP), whichever is lower. Drug companies have frequently cited the best price rule as a major roadblock to testing new drug pricing models like outcomes-based deals because they could result in steep discounts. ...