UPDATED: September 21 at 12 p.m. ET
The Trump administration announced on Sept. 18 that all 50 states, plus the District of Columbia and Puerto Rico, have applied to participate in a new model that seeks to establish most-favored nation pricing in Medicaid.
The Centers for Medicare & Medicaid Services unveiled last November the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) model, under which participating state Medicaid programs will be able to purchase certain drugs at prices that align with what is paid in other countries.
The model launched in January 2026 and will run for five years. It is voluntary for manufacturers and states, CMS said.
More than two dozen drug companies have agreed to participate in the program in exchange for tariff relief and exemptions from a similar pricing plan for Medicare, The Hill reported. The model includes hundreds of individual drugs across virtually all major drug classes, including oncology, diabetes care and asthma.
Forty states and Puerto Rico have already signed agreements to participate in the GENEROUS model, CMS said on Friday, but did not disclose which states have already signed on.
Remaining states have until Sept. 30 to sign agreements with CMS to participate in the model.
As of May, 66 million people were enrolled in Medicaid. Net spending on Medicaid prescription drugs after rebates is estimated to have grown substantially in recent years, increasing from $31 billion in FY 2019 to $46 billion in FY 2024, up 46%, according to data from health policy research group KFF.
UPDATED: March 2 at 3 p.m. ET
The White House said Monday afternoon that it will extend the deadline for drugmakers to apply for a new model that seeks to establish most-favored nation pricing in Medicaid.
The Centers for Medicare & Medicaid Services said that the application deadline for the new GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) model will be pushed back from March 31 to April 30 to allow pharmaceutical companies greater time to sign up.
State Medicaid programs that participate in GENEROUS will be able to purchase prices for drugs included in the pilot model at a price that's aligned to the price paid in other countries. The model was launched under an executive order from President Donald Trump focused on lowering drug prices.
CMS said it will begin meeting this week with manufacturers who have expressed interest in participating, and will hold a town hall for drugmakers later this spring.
The agency added that the final deadline for participation will remain June 30.
“Based on feedback from drug manufacturers, CMS has decided to give interested companies additional time to apply for the GENEROUS Model,” said CMS Administrator Mehmet Oz, M.D., in the press release. “We are committed to partnering with states and manufacturers to drive down drug prices and ensure that the most vulnerable Americans have access to life-saving medications.”
PUBLISHED: Nov. 6 at 5 p.m. ET
The Trump administration is rolling out a new model that aims to bring most-favored nation pricing to the Medicaid space.
The Centers for Medicare & Medicaid Services announced late Thursday the launch of the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) model, under which participating state Medicaid programs will be able to purchase certain drugs at prices that align with what is paid in other countries.
The agency said the model, which launches in 2026, is designed around "allowing Americans to benefit from fairer, more competitive pricing."
CMS said that total gross spending in Medicaid on drugs in 2024 was $100 billion, up by $10 billion from 2022. Through the model, CMS will negotiate with participating pharmaceutical companies to bring down prices, while states that sign on will be able to implement coverage criteria that is uniform and transparent.
This will create consistency across states for both patients and providers, CMS said.
"The GENEROUS Model will help ensure state Medicaid programs are paying a fair and reasonable price for prescription drugs—furthering our efforts to preserve funds for our most vulnerable," CMS Administrator Mehmet Oz, M.D., said in the announcement.
As part of the unveiling, CMS said it has released a request for applications from drugmakers that are interested in participating in the model as well as letters of intent from states. Medicaid agencies that express interest will be invited to formally apply down the line and can potentially opt in to terms and prices that are negotiated.
The model launch follows several deals inked between the Trump administration and key drugmakers like AstraZeneca and Pfizer to advance most-favored nation pricing. Novo Nordisk and Eli Lilly also agreed earlier on Thursday to bring down the price of their blockbuster weight loss drugs in the U.S.