Gov. Newsom’s buying consortium probably could obtain significant discounts if it exercised the same threat to walk away as the VA, given the size of the statewide market for prescription drugs. But taking a drug off the state formulary is complicated and politically fraught, in part because the change would mean that patients who have genuine need for the excluded drugs might have to pay for them out of pocket. In 2014, when Medicare proposed to take antidepressants, antipsychotics and immunosuppressants (which are used in organ transplants) off the protected list, a public uproar forced it to back down.
Source: latimes.com – Los Angeles Times