Preferred Drug List Programs

With more than 40 years of Medicaid-focused experience supporting over half the nation’s programs, Magellan Rx Management is your Medicaid pharmacy expert. Our Preferred Drug List (PDL) program goals are to help states manage high drug costs and ensure patients get the medications they need. We partner with states as fiscal stewards in Medicaid’s high-cost, high-touch system.

Visit our manufacturer hub for information on single-state programs, The Optimal PDL Solution (TOP$), National Medicaid Pooling Initiative (NMPI), diabetic supplies, and more.

Our extensive PDL experience

Our pioneered preferred drug list (PDL) and supplemental rebate program administration services currently contract with 25 states + D.C. We manage the PDL for over 33 million lives and approximately $18 billion in drug expenditures.

We developed the country’s first PDL pool, the National Medicaid Pooling Initiative (NMPI), and now provide two of the country’s three PDL pools, NMPI and The Optimal PDL $olution (TOP$). Additionally, we created the country’s first single-PDL program in 2013 and have implemented this PDL design in over a dozen states.


Next-generation PDL services

Magellan Rx supports state Medicaid programs by providing these quality PDL services:

  • Clinical analysis:

    We provide Therapeutic Class Reviews where we give our conclusions from available clinical data. We also produce other informative clinical publications, such as the MRx Pipeline, Clinical Alert, New Drug Updates, and the annual Medicaid Pharmacy Trend Report.

  • Financial analysis:

    We share cost models that project state expenditures net of all rebates in multiple scenarios.

  • Market analysis:

    We monitor all pertinent drugs from pipeline to loss of patent exclusivity and beyond.

  • PDL recommendations:

    Our pharmacist account managers know all aspects of the program components and make recommendations to states and their Pharmacy and Therapeutic (P&T) Committees.

  • Supplemental rebate negotiations:

    We are the market leader, reflected in the level of discounts achieved in Medicaid.

  • Legislative/governing body interactions:
    We collaborate with the Centers for Medicare & Medicaid Services (CMS), the Congressional Budget Office (CBO), the Office of Inspector General (OIG), and other government organizations to interpret and advise on policies affecting Medicaid.

 

 

Provider Synergies, LLC is a subsidiary of Magellan Medicaid Administration, Inc., which are part of the Magellan Rx Management, LLC .