Healthcare Economist November 13, 2025
Last week, CMS announced the GENEROUS (GENErating cost Reductions fOr U.S. Medicaid) Model. The program basically is a ‘most favored nation’ style reference pricing based on net prices from developed countries. The program builds on the Medicaid Drug Rebate Program (MDRP). Specific details specified on the CMS website include:
- Participating manufacturers whose applications are accepted will enter negotiated agreements with CMS to provide set pricing on their portfolio of covered outpatient drugs. Pricing to participating state Medicaid programs will be calculated based upon select international pricing data.
- Under agreements with states, participating manufacturers will be invoiced by states for supplemental rebates to effectuate international prices. CMS will monitor accuracy of the payments. CMS will share in rebates with states...
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