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

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Task 1.9.5 of 7

Pay pharmacies directly: a dispensing fee ($10.50 per prescription, roughly the Medicaid average) plus acquisition cost. Spread pricing and PBM rebates end.

Who does it

UHA

When

Month 18

Trade-off

Paying pharmacies directly ends PBM spread pricing but sets dispensing fees that may not sustain rural pharmacies.

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.