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Market Access

Best Price

What is the Medicaid “Best Price” Provision?
“Best Price” is a requirement for manufacturers to offer Medicaid plans the lowest price that is being offered to all payers (Veterans Affairs, Department of Defense, and Medicare Part D are excluded) in the United States. In addition, there is a defined minimum rebate that must be met- the lower of the “best price” and the minimum rebate would apply to a given drug. Failure to comply with the legislative provision would bar the company from all federal programs.

Medicaid “Best Price” has a broader impact on drug pricing and commercial and other rebate negotiations in a similar way as international reference pricing does in some countries.