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 1.9.7 of 7

Exceptions process: a physician can request a non-formulary drug, with a 72-hour decision (24 hours if urgent).

Who does it

UHA

When

Month 18

Trade-off

A non-formulary exceptions process protects individual patients but creates a new administrative channel.

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.