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Medicaid Drug Programs Data & Resources

Drug Utilization Review Annual Report:  On an annual basis, States are required to report on their State’s prescribing habits, cost savings generated from their DUR programs and their program’s operations, including adoption of new innovative DUR practices via the Medicaid Drug Utilization Review Annual Report Survey.  For more information about the DUR Survey, please visit the Drug Utilization Review page.  Please note that for FFY 2011 DUR reports, some of the information in the Tables 1 and 2 are not fully displayed due to the PDF format of the reports.  To view complete information reported for these two tables, please click on Table 1 and Table 2.

Excluded Drug Coverage by State Medicaid Program:  Effective January 1, 2006, Medicaid enrollees who are entitled to receive Medicare benefits under Part A or Part B no longer receive their pharmacy benefits under their State Medicaid agency, except for drugs that are not covered under Medicare Part D.  Each State has the option to cover these drugs for their Medicaid beneficiaries who also have Medicare coverage.  Each State has a list of excluded drugs. Please note this does not apply to the territories.

State Drug Utilization Data:  Drug utilization data are reported by States for covered outpatient drugs that are paid for by State Medicaid Agencies since the start of the Medicaid Drug Rebate Program.  To view how frequently the files are updated, please see the Medicaid Drug Rebate Program Data page.  For the web file structure and definitions without the new Record ID field, please click here [PDF].  For the web file structure and definitions with the new Record ID field, please click here [PDF].  

For an overview of Medicaid Prescription Drug Programs visit the Prescription Drugs page.

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