1. Pink Sheet
  2. >>Market Access
  3. >>Government Payers

Medicaid Cuts Could Prompt States To Tighten Drug Cost Controls, Former CMS Official Says

 
• By Cathy Kelly

Recently retired CMS veteran John Coster discussed potential Medicaid cuts, rebate cap elimination and obesity drug coverage in an interview with the Pink Sheet.

Will states tighten drug cost control in Medicaid? (Shutterstock)
Key Takeaways
  • John Coster, former Medicaid pharmacy division director, predicted states may look for savings from drug coverage restrictions if Congress imposes major Medicaid cuts.
  • Coster does not expect policies that would undercut the Medicare Drug Rebate Program because of the revenue the program generates for states.
  • The Trump Administration's decision on finalizing the Biden Administration proposal requiring Medicaid and Medicare to cover obesity drugs remains unknown, Coster said, but should be coming soon.

If Congress makes steep Medicaid cuts in the coming months, states could increase cost management for prescription drugs to offset the loss, former US Centers for Medicare and Medicaid Services...

The US House of Representatives is writing budget reconciliation legislation Medicaid stakeholders and advocates worry will include major spending reductions. A House-passed budget resolution envisions $880bn in savings from programs...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required
Start Free Trial

Already a subscriber?

More from Medicaid

House Budget Bill Includes Delayed Orphan Fix, Also Risks Downstream Cell and Gene Coverage

 
• By Sarah Karlin-Smith

The first two classes of negotiated drugs under the Inflation Reduction Act would not benefit from a rare disease adjustment House Republicans included in their reconciliation package.

Most Favored Nation Pricing Policy Floated In Medicaid, Coming Back To Medicare?

 
• By Cathy Kelly

President Trump's ongoing interest in the policy, which would ensure the US government pays no more for prescription drugs than the lowest price available in comparable countries, continues to gain attention.

If CMS Takes Over 340B, Will Government Allow Rebate Model Changes?

 
• By Cathy Kelly

Manufacturers have supported the proposed shift in oversight authority, which could create a more pharma-friendly environment in the drug discount program, but uncertainty remains.

GLP-1 Drug Coverage Growing For Obesity In Medicaid, But Only For Diabetes In Medicare

 
• By Cathy Kelly

Coverage data from the two programs suggest Medicare beneficiaries may be more disappointed than Medicaid enrollees by the Trump Administration’s decision not to mandate the programs cover obesity drugs.

More from Geography

Non-User Fee Dollars Increased In US FDA’s Updated FY 2026 Budget Request

 
• By Derrick Gingery

The budget authority total, which is significantly higher than the amount floated in an April OMB draft document, suggests there may have been successful lobbying to increase FDA funding.

US ‘Most Favored Nation’ Pricing Could be Game Changer for Drug Access In Germany

 
• By Francesca Bruce

In this first in a series of articles looking at the potential impact of the MFN drug pricing policy on European pharmaceutical markets, EUCOPE’s Alexander Natz tells the Pink Sheet why the US policy underscores the importance of confidential net pricing.

ICH Targets RWE, Rare Diseases, Biosimilars, ATMPs In New Guideline Push

 
• By Vibha Sharma

The International Council for Harmonisation has identified four new topics that can benefit from global regulatory alignment, with timelines for initiating work to be determined later.