We study the effect of privatizing Medicaid drug benefits on drug prices and utilization. Drug spending would decrease by 21.3 percent if private insurers administered all drug benefits. One-third of the decrease is driven by private insurers’ ability to negotiate prices with pharmacies. The remaining two-thirds is driven by the greater use of lower cost drugs, such as generics, and is only realized in states that give private insurers the flexibility to design drug benefits. Privatization does not reduce prescriptions per enrollee and spending cuts are smaller for drugs that lower medical spending. (JEL G22, H51, I11, I13, I18, I38, L65)

中文翻译：

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一剂管理式护理：控制医疗补助中的药物支出

我们研究了将 Medicaid 药品福利私有化对药品价格和使用的影响。如果私人保险公司管理所有药物福利，药物支出将减少 21.3%。三分之一的下降是由私人保险公司与药店协商价格的能力推动的。剩下的三分之二是由更多地使用低成本药物（如仿制药）推动的，并且只有在允许私人保险公司灵活设计药物福利的州才能实现。私有化不会减少每位参保者的处方药，而且对于降低医疗支出的药物而言，支出削减幅度较小。(JEL G22, H51, I11, I13, I18, I38, L65)