MO HEALTHNET PHARMACY PROGRAM AND BUDGET UPDATE MISSOURI PHARMACY

MO HEALTHNET PHARMACY PROGRAM AND BUDGET UPDATE MISSOURI PHARMACY ADVISORY BOARDS JULY 2023 ELIZABETH SHORT, PROGRAM SPECIALIST

May 2023 Enrollees and Expenditures Other Other (Children,Custodial Parents, Pregnant Women) (Children, Custodial Parents, Pregnant Women) 59% 84% Elderly 3% Disabled 38% Elderly 5% Disabled 11% May 2023 Enrollees Total 1,517,170 July 2022-May 2023 Expenditures Total 1,730,624,012 2

July 2022-May 2023 MO HealthNet Expenditures by Service Nursing Facilities Hospitals 10.48% 7.89% Dental Services 0.08% Managed Care Premiums 34.07% EPSDT Services 1.00% State Institutions 1.21% Rehab & Spec Mental Health Buy-In Services Svcs Premiums 16.72% 2.29% 25951942347.0 0% Pharmacy 12.87% Part D Copays 0.02% Physician Related 3.35% In-Home Services 8.10% 3

FY20-FY23(July 22-May 23) EXPENDITURES 16,000,000,000 14,000,000,000 13.4b 12,000,000,000 10,000,000,000 11.1b 10.0b 9.4b 8,000,000,000 6,000,000,000 4,000,000,000 2,000,000,000 0 1.3b 1.4b 1.5b 1.7b 1 2 3 4 Total Medicaid Expenditures Total Pharmacy Expenditures 4

MEDICAID EXPANSION May 2023 PARTICIPANTS 351,849 EXPENDITURES 59,627,162 CLAIM COUNT 447,490 5

MAVYRET EXPENDITURES 6,000,000 5,000,000 4,000,000 3,000,000 FY19 Total Spend FY20 Total Spend FY21 Total Spend FY22 Total Spend FY23 Total Spend 2,000,000 1,000,000 0 ly ug pt ct ov ec Jan eb ar pr ay ne u F M A M Ju J A Se O N D 6

TOP 10 DRUG CLASSES FOR FY 2023 DRUG FY2023 Expenditures ADALIMUMAB(Humira) 99,487,265 BIKTARVY(HIV) 66,089,032 TRULICITY(Diabetes) 51,278,722 PALIPERIDONE PALMITATE(Invega) 67,088,334 TRIKAFTA(Cystic Fibrosis) 38,794,870 MAVYRET(Hep C) 39,755,005 INSULIN ASPART(Diabetes) 38,726,312 METHYLPHENIDATE HCL(Stimulant)(Ritalin) CARIPRAZINE HCL(Schizophrenia) BUDESONIDE/FORMOTEROL FUMARATE(Asthma) 40,709,898 33,386,039 33,502,383 7

CY2023 PUPM Drug Claim Reimbursement 250 200 150 100 50 0 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Children Persons with Disabilities Custodial Parents Pregnant Women Elderly Expansion Indep Foster Care Child 8

FY2020-FY2023 Rare Disease Expenditures Per Day 500,000 450,000 400,000 350,000 300,000 250,000 200,000 150,000 100,000 50,000 0 t y ug pt v ec c l o O N D Ju A Se FY2020 Rare Disease Spend FY2022 Rare Disease Spend n eb ar ril ay ne a J F M Ap M Ju FY2021 Rare Disease Spend FY2023 Rare Disease Spend 9