Dueling Messages For Pharma From US Medicaid Formulary Plan

The innovator biopharma industry understandably concerned about a Trump Administration proposal to allow states to implement restrictive formularies while still collecting mandatory rebates. But the formulary protections in the Trump plan are an important message about the likely shape of any future changes to the US market.

two couple are showing half full and half empty side of water glass with their fingers
How should drug sponsors look at the formulary provisions of the Medicaid block grants proposal? • Source: Shutterstock

At the headline level, the big news in the Trump Administrations “Healthy Adult Opportunity” plan to cap spending in portions of the US Medicaid program is the reversal of its position on the use of formularies in the context of the mandatory “Best Price” rebate program for Medicaid.

It was just two years ago that the Trump Administration told Massachusetts it had to make a choice between restrictive...

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