Drug Pricing
Expert articles and analysis related to drug pricing.
AI Summary — Last 7 Days
CMS’ extension of the Medicaid GENEROUS Model application deadline signals strong manufacturer interest in outcomes- and affordability-oriented drug pricing arrangements under the Trump administration, creating a near-term opening for states, Medicaid plans, and pharma to test rebate structures tied to access and cost reduction. At the same time, specialty pharmacy programs are moving deeper into care management—especially for diabetes, oncology, and advanced therapies—positioning health systems and payers to pair drug spend management with adherence, outcomes tracking, and risk-based contracts. The emerging tension for VBC leaders is operational: drug pricing reform is shifting from blunt unit-cost control toward data-intensive models that require pharmacy, medical management, prior authorization, and interoperability capabilities to work together.
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