This project will inform, analyze, and assess prescription drug pricing reforms with and without enactment of the Building Back Better Act's (BBBA) drug pricing provisions. Given the uncertain legislative agenda, an authorization will provide program staff with flexibility to develop relevant, timely, and targeted projects. If new drug pricing legislation is not passed, the projects will inform administrative actions and Center for Medicare and Medicaid Innovation models, highlighting opportunities for new initiatives based on existing evidence. Likely areas of focus include how to promote greater use of the highest-value drug regimens, including those centered on generics, biosimilars, and the most cost-effective therapeutic alternatives. If the BBBA does pass, additional work will develop and/or synthesize evidence to guide implementation of the drug price negotiation and inflation rebate provisions. For all these activities, the researchers will consider how different options would affect racial equity.