Tennessee Medicaid Gets US Approval For Closed Formulary As Part Of ‘Capped’ Spending Program
Demonstration, which may not survive scrutiny from the Biden Administration, includes some protections, such as prohibiting Tennessee from excluding drugs described in the Medicare Part D protected classes policy.
You may also be interested in...
Tennessee Medicaid demonstration approved by the Trump Administration and involving capped federal spending will likely be in the cross hairs of the federal agency review and possible withdrawal ordered by President Biden. But it's unclear whether the new Administration will also object to the demonstration's closed formulary.
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.
US agency decision is a relief to manufacturers worried that the Massachusetts plan would lead to reduced drug access and heavier rebate burdens.