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New Medicaid Drug Purchasing Rules: Payments Based on Treatment Outcomes

This act changes how drugs are purchased under the Medicaid program, allowing payments to be tied to actual patient treatment outcomes. The goal is to better utilize public funds and potentially lower drug costs, especially for expensive medications, by linking price to effectiveness. Citizens may experience improved access to innovative therapies and potential savings within the healthcare system.
Key points
Medicaid drug payments can now be linked to patient treatment outcomes, meaning manufacturers might receive less if a drug doesn't perform as expected.
The act aims to increase access to modern therapies, including rare disease gene therapies, by making it easier for state programs to purchase them.
These changes are intended to potentially lower drug costs for health programs and patients, and reduce disparities in access to treatment.
The government will conduct a study to assess how these new rules impact drug access, patient outcomes, and overall healthcare costs.
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Introduced
Citizen Poll
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Additional Information
Print number: 119_S_1637
Sponsor: Sen. Mullin, Markwayne [R-OK]
Process start date: 2025-05-07