Many Americans may soon lose access to certain life-saving medicines because of a well-intentioned, but poorly designed, regulatory change that federal officials seem intent on advancing.
More than one in five Americans rely on Medicaid, which is now the nation's largest health insurer.Worryingly, these Americans may soon lose access to certain life-saving medicines because of a well-intentioned, but poorly designed, regulatory change that federal officials seem intent on advancing.For more than 30 years, Medicaid's 'best price' rule has made a simple and reasonable demand of drugmakers: Give Medicaid your lowest price or pay Medicaid a rebate of 23.
Simply put, the numerous hurdles PBMs have introduced into the system of drug procurement—every one of which is also a tollbooth contributing to their bottom lines—have made it challenging to collect the information Medicaid wants.A reform proposal worthy of consideration would start by asking PBMs what they do to actually benefit the Medicaid program as a whole and patients in particular. Spoiler alert: The answer is nothing.
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