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January 14, 2021

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2021 Outlook: Chaotic Transition Complicates Regulatory Landscape for PBMs

January 14, 2021

In the year ahead, Trump administration drug pricing policies are likely to be changed or revoked by the incoming Biden administration and court challenges, although which policies will be affected — and to what extent — is still unclear, policy experts tell AIS Health. Meanwhile, the violent attack on the Capitol by supporters of President Donald Trump may have poisoned bipartisan efforts to reform drug pricing before Congress had a chance to take them up.

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CMS Greenlights Tennessee’s Closed Medicaid Formulary Demo

January 14, 2021

When CMS on Jan. 8 approved Tennessee’s Section 1115 Medicaid waiver — making it the first state to try an “aggregate cap” approach to Medicaid financing — the agency also took the unprecedented step of authorizing Tennessee to set up a “commercial-style” closed drug formulary while still receiving statutory Medicaid drug rebates for covered drugs.

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Centene Expands Further Into Pharmacy With Magellan Deal

January 14, 2021

In addition to creating “one of the nation’s largest behavioral health platforms,” Centene Corp. will add another pharmacy-related asset to its portfolio with its recently announced $2.2 billion proposed purchase of Magellan Health, Inc.

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Prices for COVID-19 Vaccines, Drugs Could Consider Value

January 14, 2021

Payers shouldn’t write off the idea of value-based pricing for COVID-19 vaccines and therapeutics, even though the ongoing coronavirus pandemic makes it imperative to develop and release those products as quickly as possible, four Tufts Medical Center researchers say.

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