The Effective Medicaid Pharmacy Program: A White Paper for Medicaid Directors and State Agency Personnel

In June 2019, NESCSO and Commonwealth Medicine jointly released a white paper titled The Effective Medicaid Pharmacy Program. Through information compiled from stakeholder interviews and an environmental scan, this brief paper reviews components of an effective Medicaid pharmacy program and provides practical information for Medicaid programs and state leadership. An effective Medicaid pharmacy program provides members with access to medically necessary medications that are cost-effective, aligned with best clinical practice, and provided in a transparent environment. It is important consider a program’s administrative structure, pharmacy benefit delivery system, and influence of external factors in the achievement of these goals.