Prices Charged by Pharmacy Benefit Managers for Generic Drugs Were Often Markedly Higher Than the Actual Cost of the Drug in Both the Massachusetts Medicaid Managed Care and Commercial Plans, Contributing to Higher Health Care Spending

Findings and Recommendations Provide New Insights into Access Barriers for Patients with Co-Occurring Mental Illness and Substance Use Disorder, and Affordability Issues for Patients with Diabetes in the Commonwealth

State commission has authority to set benchmark between 3.1% and 3.6% until 2023

Council includes representatives from health insurers, health care providers, small and large business, state policy makers, the pharmaceutical and biotech industries, and behavioral health and consumer advocacy groups

Since 2014, a significant number of consumers received coverage for medically necessary care as a result of Massachusetts patient protection rights administered/regulated by the HPC’s Office of Patient Protection

Findings and Recommendations from Annual Cost Trends Report and Study on Availability of Co-Occurring Disorders Treatment

Findings Will Inform Panel Discussion at Cost Trends Hearing, October 16-17, 2018

Report Referred to Attorney General and Department of Public Health for Further Consideration