The Medicare Drug Price Negotiation Program - What Now?
The Inflation Reduction Act (IRA) of 2022 established the Medicare Drug Price Negotiation Program, which enabled CMS to negotiate a maximum fair price.
The Inflation Reduction Act (IRA) OF 2022 established the Medicare Drug Price Negotiation Program, which enabled CMS (Centers for Medicare & Medicaid Services) to negotiate a maximum fair price (MFP) for drugs and biologics. The first 10 drugs for Medicare Part D negotiations were announced in 2023, with negotiated pricing for these products finally went into effect Jan. 1, 2026. This year also ushered in several other new changes to the program. First and foremost, Part B drugs can now be selected for negotiation, with the first of those drugs’ negotiated prices going into effect in 2028. Second, previously selected products may now be selected for renegotiation. It is also noteworthy that the orphan drug exclusion has been expanded. With these new changes, what should the industry expect for 2026 and beyond?
Beyond the Projected Savings: Navigating the Next Wave of Medicare Drug Price Negotiations
Why are actual IRA savings falling short of projections, and what does the shifting competitive landscape mean for CMS renegotiations? Ann Johnson breaks down the mechanics of the new Part B inclusion, its threat to physician reimbursement, and how the Working Families Tax Cuts Act of 2025 reshapes the orphan drug market.
