Guidance Revised for Medicare Drug Price Negotiation Program

1 minute read

As part of the Inflation Reduction Act, Medicare will soon be able to directly negotiate covered prescription drug prices (Part B and Part D). The Centers for Medicare and Medicaid Services (CMS) released revised guidance regarding using its authority with pharmaceutical manufacturers in the Medicare Drug Negotiation Program.

Guidance Updates

The guidance was created to improve the transparency and the negotiation process. Here are some key items updated.

• Clarification on how CMS will identify selected drugs
• Additional opportunities for drug companies and the public to engage the CMS during the negotiation process
• Revisions and clarifications on the process for participating drug companies

Next Steps

In the fall, the CMS will hold listening sessions for patients, caregivers, and patient advocacy organizations to share their input on the selected drugs. By September 1, 2023, the CMS will announce the first 10 drugs covered under Part D selected for the initial price applicability year 2026. By September 1, 2024, the maximum fair prices negotiated will be published and prices are effective January 1, 2026. Up to 15 more negotiated drugs will be selected for 2027 and 2028. And up to 20 more drugs for each year after that. For more information, download the bulletin.