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When the Trump administration rolled out its drug pricing blueprint in May 2018, framing it as its plan to make good on one of the president’s signature campaign promises, it promised to shake up how Americans pay for prescription drugs.

But in May, the administration abandoned a proposal to allow private Medicare plans to refuse to pay for certain drugs in so-called “protected classes” if they spiked in price. Earlier this week, a federal judge blocked its regulation that would have required drug makers to include list prices in ads. And on Wednesday, the administration pulled the plug on its effort to ban many of the rebates that drug companies pay to pharmacy benefit managers under Medicare.

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The collapse of so many of President Trump’s signature drug pricing initiatives has left analysts and experts wondering what cards, if any, the administration still has up its sleeve. The 2020 election only heightens the pressure on the administration to make an impact on an issue at the forefront of voters’ minds, especially as Democratic presidential candidates tout their own drug pricing plans.

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