Q&A_as_of_5252018_-_MACPAC_Pharmaceutical_Claims_for_Research_-_RxClaims2018.pdf

Medicaid and CHIP Payment and Access Commission (MACPAC) Pharmaceutical Claims for Research - RxClaims2018

RESPONSE TO QUESTIONS

Question # Bidder Question MACPAC Response

1.

Is this a new requirement or is there an incumbent vendor? If available, can you please send along the incumbent contract number?

There is no requirement for this. There is also no incumbent vendor currently providing this data.

2.

Verify that the request for Rx and Medical claims are for all therapeutic classes for all pharmaceutical products.

This is not specific to a defined group of drugs.

MACPAC staff only want to look at a subset of drugs, approximately 200 drugs not specific to any therapeutic class. Please provide pricing for both a subset of drugs as well as all drugs.

For most drugs MACPAC does not need to differentiate between various formulations or dosages. For some, however, such as buprenorphine, we may want to capture available detail related to different formulations or dosages. Additionally, we would welcome information about the extent to which the vendor’s data captures physician-administered drugs.

3.

Will the medical claims definition be just as broad or will it be based on the medically administered pharmaceutical products associated with a Medical or Hospital claim?

MACPAC is interested in any medical claims data for individuals who had a pharmaceutical claim for one of the drugs in the aforementioned subset (see Question 2) of approximately 200 drugs, even if the medical claim is unrelated to the diagnosis for which the drug was prescribed.