Recent Trends in Medicaid Outpatient Prescription Drugs and Spending Author: Elizabeth Williams Published: Mar 12, 2026

https://www.kff.org/medicaid/recent-trends-in-medicaid-outpatient-prescription-drugs-and-spending/?utm_campaign=KFF-Medicaid&utm_medium=email&_hsenc=p2ANqtz-8XWnhFlvi19xYkDV2PomxK9OjXrWG74Fc0oRgQ-a4XhSQms-4N1qpHOyvS4_LA9bJ_hXwO7ZfbME2OQJlF8KbF_2pPeQ&_hsmi=408681787&utm_content=408681787&utm_source=hs_email KFF Examines Recent Trends in Medicaid Outpatient Prescription Drugs and Spending A new KFF issue brief describes recent trends in the number of Medicaid outpatient prescriptions and spending on those drugs, and also examines the implications of recent federal policy actions. The analysis finds that net spending after rebates on Medicaid prescription drugs has grown substantially in recent years, rising by 46% from $31 billion in FY 2019 to $46 billion in FY 2024, due in part to high-cost drugs like GLP-1s and gene therapies. Both net spending per prescription and net spending per enrollee also grew over the period, while the number of prescriptions paid for by Medicaid only grew slightly over that period. Rebates from drug manufacturers – including those required by federal law for drugs covered by Medicaid – reduced gross Medicaid prescription drug spending by an average of 53% from FY 2019 to FY 2024. State supplemental rebates, which states negotiate directly with manufacturers, make up a growing share of all Medicaid drug rebates. It remains unclear how federal changes in the 2025 reconciliation law and recent federal prescription drug initiatives like “most-favored nation” drug pricing will affect future spending on prescription drugs. Also available is KFF’s new explainer on how Medicaid covers and pays for access to prescription drugs for one in five people in the U.S. https://www.kff.org/medicaid/5-key-facts-about-medicaid-prescription-drugs/?utm_campaign=KFF-Medicaid&utm_medium=email&_hsenc=p2ANqtz-9tA0eKIOzcGyliKGP8ES3Q6y2Rc5bPip-aaOQ0puV9CFc9JcK6LQPjUc3qZWAyt3AmjNpipf4dmkx3NLVRgFgLncYOhg&_hsmi=408681787&utm_content=408681787&utm_source=hs_email Contact: Tammie Smith | 202.654.1410 | TammieS@kff.org