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Drug Pricing & Part D

Expert articles and analysis related to drug pricing & part d.

25 articles•Last 24 Hours

AI Summary — Last 24 Hours

CMS extended the application deadline for drug manufacturers in the Medicaid-focused GENEROUS Model, signaling strong pharma interest in a Trump administration test of outcomes- and affordability-oriented drug pricing tools that could affect state Medicaid purchasing strategy and supplemental rebate dynamics. At the same time, CMS’s proposed drug interoperability and prior authorization rule would push payers and providers toward more standardized electronic exchange for pharmacy benefit decisions, with near-term implications for MA, Medicaid managed care, ACO care teams, and specialty pharmacy workflows managing high-cost drugs and oncology access barriers. See: GENEROUS Model deadline extension and drug interoperability/prior authorization proposed rule summary.

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