Create the national formulary & negotiate drug prices

Months 0–18 for the initial formulary; continuous negotiation · National Formulary and Pricing Board; HTA InstituteDiscuss this step

340B Drug Pricing Program

replacedYear 2Provider payment & regulation

Today

Safety-net hospitals and clinics buy outpatient drugs at deep discounts and keep the spread from insurer reimbursement (tens of billions a year).

Under the plan

Ends as a revenue mechanism: UHP pays negotiated drug prices to all; the lost spread is replaced by explicit safety-net budget adjustments.

Trade-off

Ends an opaque subsidy that partly flows to well-off systems and contract pharmacies; covered entities lose flexible revenue.