Becker's Healthcare November 6, 2025
CMS is set to launch a pricing model in January that could reshape Medicaid drug costs by aligning them with rates seen in other high-income countries.
Eight things to know:
1. The program allows participating drug manufacturers to offer Medicaid programs drug prices similar to those in select other countries, such as those in Europe or Canada. This “most-favored-nation” pricing model aims to curb the high cost of medications in the U.S., according to the agency.
2. CMS said the pilot targets rapidly rising Medicaid drug spending. In 2024, gross Medicaid spending on prescription drugs exceeded $100 billion, with net spending at $60 billion after manufacturer rebates. The program is designed to reduce this burden on state and federal...
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