Policy moves in the US centered on Medicaid drug pricing and Medicare outcomes payments. President Donald Trump announced that all 50 states plus DC and Puerto Rico will participate in a new Medicaid drug pricing model tied to supplemental rebates, aiming to align Medicaid net pricing. Separately, CMS expanded its ACCESS model in spring 2027 to cover additional chronic conditions including heart failure, COPD, substance use disorders, and tobacco cessation. CMS said the outcomes-based payment structure launched in July with participating providers and will cover roughly three in four Medicare beneficiaries for at least one track. Together, the steps increase the regulatory focus on net pricing and outcomes accountability, shaping how payers evaluate evidence for therapeutic value and pricing strategies across both commercial and government channels.