W

ASHINGTON — The Trump administration wants states to experiment with drug prices — but not too much.

In a pair of decisions Wednesday, top health officials offered the first clear signals of just how far they will let state Medicaid agencies go when it comes to negotiating discounts for prescription drugs. The administration declined to approve a bolder proposal from Massachusetts to use a formulary to exclude some drugs from Medicaid coverage, a common negotiating tactic for commercial plans. At the same time, it approved a separate idea from Oklahoma to let the state’s Medicaid program negotiate extra rebates if a given drug isn’t as effective as expected.

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