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For example, declining demand doesnt reliably mean lower prices

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CMS would pay a lower upfront price while sharing Medicare long-term savings with manufacturers if and when they are realized

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After a number of years of robust revenue growth right after the pandemic, states are starting to see slowing revenues, increasing spending demands and a lot of fiscal uncertainty due in part to recent federal actions. In April, the Trump administration scrapped a Biden-era proposal that would have required state Medicaid programs to pay for some GLP-1s for obesity treatment