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CMS announces drugs for third cycle of Medicare Drug Price Negotiation Program
CMS announced the selection of 15 drugs covered under Medicare Part D and, for the first time, drugs payable under Medicare Part B for the third cycle of the Medicare Drug Price Negotiation Program with negotiated prices effective in 2028.
What you need to know about the Inflation Reduction Act
The Inflation Reduction Act (IRA), which was signed into law in August 2022, is a complex law that contains healthcare reforms, tax changes, and environmental policy provisions that impact several aspects of the U.S. healthcare ecosystem. The IRA aims to address rising healthcare costs by exploring innovative pricing models that seek to prioritize access, value, and quality.
The Medicare Drug Price Negotiation Program:
Essentials for providers
For the first time, the IRA provides Medicare the ability to directly negotiation maximum fair pricing (MFP) of certain high expenditure, single source drugs without generic or biosimilar competition. Part D drugs are eligible for MFP beginning in 2026 while Part B drugs will be eligible starting in 2028.
Did you know?
The first round of maximum fair prices began on January 1, 2026
For manufacturers and impacted providers
Building a prospective solution for efficient MFP payments
Having a sustainable market-wide process to accurately and efficiently effectuate MFPs is crucial to enabling patient access to vital medications. That’s why we are building an innovative, prospective solution to assist in implementing more efficient MFP refunds by streamlining the gathering of data, calculating refunds, and transmitting data to providers and manufacturers.
For manufacturers
Valuable insights and support to help you navigate the IRA
The Inflation Reduction Act (IRA) contains implications that pharmaceutical manufacturers need to consider across the full drug discovery, development, and commercialization spectrum. With insights on key elements and a comprehensive understanding of the IRA, our team of experts are here to help you prepare for potential impacts.
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