Variations in Generic Combination Opioid Use Across State Medicaid Programs

Despite the availability of inexpensive generic oxycodone-acetaminophen since the 1980s, it took over 30 years to reach a 90% generic dispensing rate in Medicaid, with substantial state-level variation.Continued brand-name use cost Medicaid an estimated $239 million ($108 million after rebates) for oxycodone-acetaminophen alone from 1998 to 2018. These findings highlight missed opportunities for cost savings through more timely and consistent generic substitution of commonly prescribed combination opioids across state Medicaid programs.