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In its latest effort to attack high drug costs, the Trump administration wants to allow privately run Medicare Advantage plans to require patients to pursue step therapy, which means anyone who needs a costly, physician-administered drug must first try a cheaper medicine to see if it works.

With about 19 million beneficiaries covered by these plans, the move is projected to save 15 percent to 20 percent of the $11.9 billion spent on Part B drugs, which are infused or injected medicines. Some of these are pricey specialty drugs for hard-to-treat diseases and ailments.

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