Medicare Negotiation’s Drug Reformulation Problem

The authors shed light on a loophole in the Medicare Drug Price Negotiation program: once a generic version of any formulation of a drug is marketed, all formulations of that drug are exempted from negotiation. They detail how this loophole could enable costly gamesmanship, listing expensive drugs that could be excluded through this technicality. Instead, negotiation eligibility should be determined by aggregating Medicare spending on all formulations that do not face bona fide competition.