New York Medicaid Saves $500 million

States like New York have already been looking to ICER as an independent arbiter of cost-effectiveness. At a public meeting in July 2020, New York’s Drug Utilization Review Board voted unanimously (14-0) to seek a supplemental Medicaid rebate that would result in a 79% discount off the treatment’s list price — a discount consistent with ICER’s cost-effectiveness price benchmark.

During the meeting, the state’s Department of Health reinforced that these upcoming negotiations with Biogen around this supplemental rebate will not jeopardize access for any patient. Excluding the drug is not an option; the state is simply seeking a price that better aligns with the treatment’s benefits. Following the meeting, New York has saved nearly $500 million since 2018 by using this process to negotiate supplemental Medicaid rebates on approximately 50 drugs. It’s no wonder other states (e.g., Massachusetts) are pursuing similar approaches.