Oklahoma State Medicaid Adopts Drug Price Benchmark, PAC

OK Medicaid selects Predictive Acquisition Cost (PAC) to improve efficiencies in managing pharmacy reimbursement and reduce drug spend

Tampa, FL, October 1, 2013

Elsevier, the leading provider of scientific, technical and medical information products and services, announced today that Oklahoma State Medicaid, managed by Oklahoma Health Care Authority – SoonerCare, has selected Predictive Acquisition Cost (PAC) to better manage its State Maximum Allowable Cost (SMAC) drug price list to improve administration efficiencies and reduce overall drug spend.

PAC, developed by Glass Box Analytics and exclusively published by Elsevier's Gold Standard, is a new drug price type that more closely tracks true acquisition cost by leveraging proven concepts from other industries and applying the power of predictive analytics to drug pricing. Independent tests show that PAC comes closer to true acquisition cost than alternatives.

SoonerCare (Oklahoma Medicaid) is a health coverage program jointly funded by the federal and state government. The Oklahoma Health Care Authority (OHCA) is the state agency that administers and determines financial eligibility for the program. SoonerCare currently serves more than 790,000 members under the fee for service pharmacy benefit.

In search of a more efficient method for managing pharmacy reimbursement, the agency found that PAC is cost effective and allows for better analysis of drug cost and reimbursement amounts.

"PAC provides an accurate reflection of the true acquisition cost for all drugs and helps our agency know where to set SMAC prices that reflect the true drug cost. The goal of the SMAC program is to set reimbursement that is fair to both the state and to the parties we reimburse," said SoonerCare Pharmacy Director Nancy Nesser. "It gives us accurate information that is easily accessible and requires fewer resources. Reimbursement should reflect the best estimate of acquisition cost, and we feel with PAC that we can achieve this."

State Medicaid programs can save significantly by using PAC to evaluate their state MAC lists. PAC displays a price range for each specific drug. The state MAC should lie within that range. PAC identifies cases where reimbursement is too high or too low, which allows Medicaid programs to ensure that their pharmacies are being reimbursed at market-based rates. SoonerCare will also be utilizing PAC to track the true costs of specialty drugs.

"All state Medicaid programs are seeking ways to improve pharmacy reimbursement management and Oklahoma was already doing a great job," said Kay Morgan, Vice President, Drug Products & Industry Standards, Elsevier. "In PAC, they recognized an innovation that would help them reduce prescription drug costs further, while also improving operational efficiencies."

For more information about Elsevier's Gold Standard, visit www.goldstandard.com.

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About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

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Media contact
Christopher Capot
Director, Corporate Relations, Elsevier
+1 212 633 3164
c.capot@elsevier.com