Medicaid’s GENEROUS Most-Favored-Nation Pricing Model — Promise and Limitations

Por: Maini, Luca [Autor]Colaborador(es): Sachs, Rachel E | Kyle, Michael Anne | Kakani, PragyaTipo de material: TextoTextoIdioma: Inglés Descripción: páginas: 1772-1774Tema(s): COSTO DE LA ATENCIÓN MÉDICA | MEDICAMENTOS, DISPOSITIVOS Y LA FDA | MEDICARE | MEDICAID | IMPLEMENTACIÓN DE LA REFORMA En: The New England Journal of MedicineResumen: On November 10, 2025, the Centers for Medicare and Medicaid Services (CMS) released a request for applications seeking pharmaceutical manufacturer participation in the GENEROUS (Generating Cost Reductions for U.S. Medicaid) model — a pilot program intended to reduce Medicaid drug spending and improve drug access. Under the program, participating manufacturers will offer supplemental rebates tied to prices in non-U.S. Group of Seven (G7) countries (Canada, France, Germany, Italy, Japan, and the United Kingdom) plus Denmark and Switzerland in exchange for federally negotiated coverage criteria. State Medicaid programs will then decide whether to accept those coverage terms. Participating states will forgo any additional state-specific rebates they previously negotiated but will retain Medicaid Drug Rebate Program (MDRP) statutory rebates.
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Colección General NEJM (Navegar estantería) Vol.394, No.18 (2026) Disponible NEJM015

On November 10, 2025, the Centers for Medicare and Medicaid Services (CMS) released a request for applications seeking pharmaceutical manufacturer participation in the GENEROUS (Generating Cost Reductions for U.S. Medicaid) model — a pilot program intended to reduce Medicaid drug spending and improve drug access. Under the program, participating manufacturers will offer supplemental rebates tied to prices in non-U.S. Group of Seven (G7) countries (Canada, France, Germany, Italy, Japan, and the United Kingdom) plus Denmark and Switzerland in exchange for federally negotiated coverage criteria. State Medicaid programs will then decide whether to accept those coverage terms. Participating states will forgo any additional state-specific rebates they previously negotiated but will retain Medicaid Drug Rebate Program (MDRP) statutory rebates.