I am genuinely exited about the topic (too much coffee I guess).
I think the Medicare administration should be allowed to exclude an FDA approved pharmaceutical from its formulary if a committee of doctors agrees that there is a cheaper equally effective alternative. I also think that this should only be allowed after the medicare administration engages in good faith negotiations with the manufacturer lasting at least 60 days and ending in an impass (wording like the Taft-Hartley act wording on strikes). Finally I think the medicare administration should publicize it's list of FDA approved drupgs not in the formulary (that is for which it will not pay) with press releases, on the web and along with all payments to physicians.