Medicaid Drug Formulary Ideas Floated, But US Manufacturers Are Skeptical
Medicaid formularies capable of excluding drugs to drive better rebates could replace the existing drug rebate program, lobbyists suggest, but US manufacturers worry that lawmakers will be leery of losing statutory-based rebates.
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States might also be able to test closed formularies in Medicaid as Trump Administration seeks stronger disincentives for price increases.
State requests waiver from Centers for Medicare and Medicaid Services to use closed formulary in its Medicaid program as a way to lower prescription drug costs.
Amgen has negotiated 75 value-based contracts – agreements that SVP Josh Ofman sees as one area where biopharma and payer views are aligned. However, tension between the two sides remains high in pricing and reimbursement negotiations when it comes to rebates and other issues.