Pursuant to Connecticut General Statute § 19a-754b (d), the CT Office of Health Strategy is releasing a preliminary list of Outpatient Prescription Drugs Provided at a Substantial Cost for public comment.
Please see the 2025 notice and report at the site here: https://portal.ct.gov/ohs/programs-and-initiatives/prescription-drug-cost-transparency or directly here: 2025 Notice and Report. The list includes the top highest cost outpatient drugs, total costs and utilization for commercial, CT state employee, Medicare Advantage and Medicaid markets, and the wholesale acquisition costs and increases. The claims data is from the calendar year 2023.
The list must be based on the specifications outlined in Conn. Gen. Stat. § 19a-754b (d).
- The list of not more than ten outpatient drugs are (A) provided at substantial cost to the state, considering the net cost of such drugs, or (B) critical to public health.
- The list must include drugs from different therapeutic classes of outpatient prescription drugs;
- The list must include not less than one generic drug;
- The wholesale acquisition cost (WAC) of such outpatient prescription drug (A) increased by not less than sixteen per cent cumulatively during the immediately preceding two calendar years, and (B) was not less than forty dollars for a course of treatment.
During the public comment period, any manufacturer of an outpatient prescription drug included on the preliminary list may produce documentation, as permitted by federal law, to OHS to establish that the wholesale acquisition cost of such drug, less all rebates paid to the state for such outpatient prescription drug during the immediately preceding calendar year, does not exceed the limits established in the specifications.
Please direct any public comments and documentation to patricia.blodgett@ct.gov by March 12, 2025.