US Medicare drug pricing reform implementation

The implementation of drug pricing reforms under the Inflation Reduction Act has entered a phase of operational adjustment and regulatory expansion. Following the January 2026 launch of the Medicare Maximum Fair Price (MFP) program, health systems and pharmacies have faced administrative challenges regarding post-payment adjustments and dispute tracking. Concurrently, bipartisan legislative efforts in the House have targeted pharmacy benefit managers (PBMs) to ensure fair reimbursement and transparency.

Building on these developments, the Centers for Medicare & Medicaid Services (CMS) has proposed a rule to codify the Medicare Drug Price Negotiation Program (MDPNP). This proposal seeks to establish policies for 2029 and beyond, potentially expanding the program to include nearly 60 drugs in future negotiation cycles. While the program is currently in its third cycle negotiating prices for 15 drugs, the new regulatory framework aims to provide long-term certainty for manufacturers while managing high-expenditure, single-source drugs.