Phase 1: Enactment & build · Step 1.9

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

← All tasks for this step

Task 1.9.3 of 7

Run full negotiations for the 500 highest-spend brand drugs over Years 1–3, using value assessments from the HTA Institute.

Who does it

Formulary Board / HTA Institute

When

Years 1–3

Trade-off

Negotiating the top 500 drugs first targets most spending but leaves cheaper brands at higher prices for longer.

Part of: Create the national formulary & negotiate drug prices

A National Formulary and Pricing Board covers every FDA-approved drug with a negotiated price. Retail drug spending falls from $467.0B to $380.1B (price effect −$113.1B, utilization +$26.2B).

This step changes 10 existing laws, programs, or institutions. See the list.