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

Medicare Part D (drug plans)

replacedYear 1Federal programs

Today

Standalone and MA drug plans run by private sponsors and PBMs; $2,000 out-of-pocket cap (2025); IRA negotiation of selected drugs.

Under the plan

Replaced by the national formulary with $0 cost sharing. IRA negotiation is extended to all drugs.

Trade-off

No premiums or cost sharing; formulary choice moves from plan competition to one public formulary with an exceptions process.