WASHINGTON — 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.
The Massachusetts decision is more consequential, in part because the proposal was inherently more controversial. It is also a setback for health officials in Massachusetts, who had painted the proposal as a bold plan to help lower the cost of prescription drugs, in keeping with the Trump administration’s other regulatory efforts in that space. And it’s a win for pharmaceutical companies and patient groups that had opposed the idea of Medicaid formularies, saying they would deny Medicaid beneficiaries in the state access to lifesaving treatments.
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