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Medicaid, Under the Influence
Liz Essley White, Joe Yerardi and Alison Fitzgerald Kodjak

In “Medicaid, Under the Influence,” The Center for Public Integrity and National Public Radio (NPR) offered a compelling and accessible look at the myriad ways the drug industry works to keep Medicaid funds flowing to the pharmaceutical companies. The investigation revealed a system of high-pressure and high-stakes lobbying that is replete with financial conflicts of interest. Since Medicaid only pays for drugs that are on its socalled “preferred drug list,” company sales reps woo doctors to not only prescribe specific drugs, but to help sway the state committees that decide which medications get preferential treatment. With one lobbyist for every three state lawmakers, the drug companies maintain a massive presence in how state governments allocate their budgets; meanwhile, corporations and foundations donate tens of millions of dollars to support patient advocacy groups that lobby state lawmakers for their causes. Another story highlighted a possible solution, with the state of Louisiana negotiating directly with a drug company over one very expensive medication. The fallout from these audio reports caused a number of states to crack down on conflicts of interest and/or to demand additional disclosures from the drug companies.

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