# Drug Price Negotiation * **Definition:** The process by which Medicare negotiates prices for prescription drugs with manufacturers to secure lower costs for beneficiaries, including establishing a Maximum Fair Price (MFP) for eligible drugs covered under Medicare Parts B and D. * **Taxonomy:** Healthcare Topics / Drug Price Negotiation ## News * Selected news on the topic of **Drug Price Negotiation**, for healthcare technology leaders * 2.7K news items are in the system for this topic * Posts have been filtered for tech and healthcare-related keywords | Date | Title | Source | | --- | --- | --- | | 5/16/2025 | [**Opinion: STAT+: The FDA is embracing AI boldly. Now it must show what responsible innovation looks like**](https://www.statnews.com/2025/05/16/fda-generative-ai-medical-product-review-offices-transparency-regulation/?utm_campaign=rss) | [[STAT]] | | 5/14/2025 | [**Administration Releases Medicare Drug Price Negotiation Program Draft Guidance For 2028**](https://www.healthaffairs.org/content/forefront/administration-releases-medicare-drug-price-negotiation-program-draft-guidance-2028) | [[Health Affairs]] | | 4/17/2025 | [**NCPA Raises Concerns About Implementation of Medicare Drug Price Negotiation Program**](https://www.pharmacytimes.com/view/ncpa-raises-concerns-about-implementation-of-medicare-drug-price-negotiation-program) | [[Pharmacy Times]] | | 4/16/2025 | [**Trump Signs Executive Order to Lower Drug Prices**](https://www.ajmc.com/view/trump-signs-executive-order-to-lower-drug-prices) | [[AJMC]] | | 4/16/2025 | [**Trump order seeks changes to Medicare drug price negotiation program, PBM reform**](https://www.fiercehealthcare.com/payers/trump-order-seeks-changes-medicare-drug-price-negotiation-program-pbm-reform) | [[FierceHealthcare]] | | 1/30/2025 | [**New Analysis Finds the Medicare Drug Price Negotiation Program Threatens Financial Stability of American Pharmacies**](http://www.businesswire.com/news/home/20250130548651/en/New-Analysis-Finds-the-Medicare-Drug-Price-Negotiation-Program-Threatens-Financial-Stability-of-American-Pharmacies/?feedref=JjAwJuNHiystnCoBq_hl-RLXHJgazfQJNuOVHefdHP-D8R-QU5o2AvY8bhI9uvWSD8DYIYv4TIC1g1u0AKcacnnViVjtb72bOP4-4nHK5ieT3WxPE8m_kWI77F87CseT) | [[Business Wire]] | | 1/29/2025 | [**From Admission to Discharge: How AI Reduces Hospital Length of Stay - MedCity News**](https://medcitynews.com/2025/01/from-admission-to-discharge-how-ai-reduces-hospital-length-of-stay/) | [[MedCity News]] | | 1/29/2025 | [**The 7 big topics RFK Jr. addressed during a fiery confirmation hearing - STAT News**](https://www.statnews.com/2025/01/29/rfk-jr-confirmation-hearing-key-takeaways-trump-health-secretary-nominee/) | [[STAT]] | | 1/28/2025 | [**Walgreens Unlikely To Sell To Private Equity Firm Sycamore Partners - KFF Health News**](https://kffhealthnews.org/morning-breakout/walgreens-unlikely-to-sell-to-private-equity-firm-sycamore-partners/) | [[KFF Health News]] | | 1/27/2025 | [**Will the Medicare Drug Price Negotiation increase innovation?**](https://www.healthcare-economist.com/2025/01/27/will-the-medicare-drug-price-negotiation-increase-innovation/) | [[Healthcare Economist]] | | 1/20/2025 | [**How Healthcare Leaders Reacted to the 15 Additional Drugs Selected for Medicare Negotiation Program**](https://medcitynews.com/2025/01/medicare-drug-prices-negotiation/) | [[MedCity News]] | | 1/17/2025 | [**Teva files lawsuit against drug-price negotiations - Healthcare Finance News**](https://www.healthcarefinancenews.com/news/teva-files-lawsuit-against-drug-price-negotiations) | [[Healthcare Finance]] | | 1/14/2025 | [**Healthcare Trends Shaping 2025 And Insights For Industry Leaders - Forbes**](https://www.forbes.com/councils/forbesbusinesscouncil/2025/01/14/healthcare-trends-shaping-2025-and-insights-for-industry-leaders/) | [[Forbes]] | | 1/2/2025 | [**5 Large Drug Stocks to Keep An Eye On in the New Year - Yahoo Finance**](https://finance.yahoo.com/news/5-large-drug-stocks-keep-134100753.html) | [[Yahoo Finance]] | | 12/26/2024 | [**The Business and Finance of Healthcare in 2025**](https://www.healthitanswers.net/the-business-and-finance-of-healthcare-in-2025/) | [[Health IT Answers]] | | 12/14/2024 | [**ICYMI: Highlights From COA 2024**](https://www.ajmc.com/view/icymi-highlights-from-coa-2024) | [[AJMC]] | | 12/12/2024 | [**Experts Weigh Benefits of Drug Price Negotiation and Other Price-Curbing Strategies**](https://www.medpagetoday.com/publichealthpolicy/medicare/113368) | [[Medpage Today]] | | 12/12/2024 | [**GLP-1 barriers begin to break down**](https://www.beckershospitalreview.com/glp-1s/glp-1-barriers-begin-to-break-down.html) | [[Beckers Hospital Review]] | | 11/11/2024 | [**Risk of aspiration during surgery added to GLP-1 drug labels - STAT News**](https://www.statnews.com/2024/11/11/biotech-news-fda-glp-1-rfk-jr-gsk-bio-medicare-gop-trump-pfizer-the-readout/) | [[STAT]] | | 11/7/2024 | [**What Trump's election means for healthcare**](https://www.healthcarefinancenews.com/news/what-trumps-election-means-healthcare) | [[Healthcare Finance]] | | 10/10/2024 | [**3 things to know about Harris' home care plan**](https://www.politico.com/newsletters/politico-pulse/2024/10/10/3-things-to-know-about-harris-home-care-plan-00183164) | [[Politico]] | | 8/20/2024 | [**IRA Drug Price Negotiation Savings Dominated by 3 Medications**](https://www.ajmc.com/view/ira-drug-price-negotiation-savings-dominated-by-3-medications) | [[AJMC]] | | 7/17/2024 | [**Zacks Industry Outlook Eli Lilly, Novo Nordisk, Merck and Pfizer**](https://finance.yahoo.com/news/zacks-industry-outlook-eli-lilly-133600221.html) | [[Yahoo Finance]] | | 7/16/2024 | [**4 Large Drug Stocks to Watch as Innovation, M&A Pick Up**](https://finance.yahoo.com/news/4-large-drug-stocks-watch-125300453.html) | [[Yahoo Finance]] | | 9/7/2023 | [**How the drug price negotiation program could affect Medicare Part D beneficiaries**](https://www.statnews.com/2023/09/08/medicare-part-d-drug-price-negotiations/) | [[STAT]] | ## Topic Overview (Some LLM-derived content — please confirm with above primary sources) ### Key Players - **Centers for Medicare & Medicaid Services (CMS)**: The federal agency responsible for implementing the drug price negotiation program under Medicare. - **Pharmaceutical Benefit Managers (PBMs)**: Entities that handle negotiations and pricing for medications, contributing to the complexity of U.S. drug pricing. - **Boehringer Ingelheim**: A pharmaceutical company that challenged the legality of the drug price negotiation program. - **CMS**: Centers for Medicare & Medicaid Services, responsible for implementing the Medicare Drug Price Negotiation Program. - **Pharmaceutical Companies**: Major drug manufacturers that are subject to price negotiations and have filed lawsuits against the Inflation Reduction Act, claiming it violates their rights. - **Biden Administration**: The current U.S. government administration that has implemented the Drug Price Negotiation Program to lower prescription drug costs. - **Kevin Schulman**: Health economist who has studied drug price negotiations and advocated for reference pricing systems. - **President Joe Biden**: The U.S. President advocating for drug price negotiations to lower healthcare costs. - **Trump Administration**: The political leadership that may influence drug price negotiation policies, particularly regarding the Inflation Reduction Act. - **Teva Pharmaceuticals**: A pharmaceutical company actively suing CMS over the drug price negotiation program. - **DrMehmetOz**: Appointed to lead the Centers for Medicare & Medicaid Services, influencing drug price negotiation policies. - **Centers for Medicare and Medicaid Services (CMS)**: The federal agency responsible for administering Medicare and Medicaid, overseeing the drug price negotiation program. - **Senator Bernie Sanders**: A key political figure collaborating with Biden to enhance drug price negotiation efforts. - **Eli Lilly**: A pharmaceutical company that has partnered with telehealth services to improve access to medications amid ongoing drug price negotiations. - **AstraZeneca**: A pharmaceutical company that faced legal challenges regarding Medicare's drug price negotiations. - **DCCA**: Data Computer Corporation of America, a Veteran-Owned Business, awarded a $60 million contract by CMS to develop the Medicare Transaction Facilitator Data Module for drug price negotiation. ### Partnerships and Collaborations - **MultidisciplinaryTeam**: Formed to guide the implementation of the Medicare Drug Price Negotiation Program, emphasizing stakeholder engagement. - **Biden and Sanders Collaboration**: Joint efforts to expand the Medicare Drug Price Negotiation Program from 10 to 50 drugs annually. - **Harvard Medical School**: Collaborated with Schulman and Syversen on a comparative study of drug price negotiations across different countries. - **CMS and Medicare Transaction Facilitator**: CMS plans to collaborate with a Medicare Transaction Facilitator to enhance the drug price negotiation process. - **Avalere Health**: Hosted an online panel discussion with policy experts discussing potential health policy changes related to drug price negotiations. - **Optum Rx and Drugmakers**: Optum Rx has pledged to pass through 100% of negotiated rebates to clients, aiming for greater transparency in drug pricing. - **Stakeholder Engagement**: CMS will host monthly technical calls and patient-focused roundtables to gather feedback from pharmacies and patients regarding the negotiation process. - **Institute for Value-Based Medicine**: Organized discussions on strategies to enhance patient outcomes and manage healthcare costs related to neurological diseases. - **Mark Cuban's Involvement**: Cuban has engaged in discussions around transparency in pharmacy benefit managers (PBMs) and healthcare initiatives, indicating a collaboration with the administration. - **Community Oncology Alliance (COA)**: Focused on challenges in oncology care and drug price negotiations under the Inflation Reduction Act. - **Pfizer Licensing Agreement**: A deal enabling the global production of a generic version of its COVID-19 antiviral pill, increasing access to medications. - **Eli Lilly and Ro**: A partnership to enhance access to Zepbound prescriptions through telehealth, aimed at improving patient access amid high demand. - **BipartisanSupport**: Harris's proposal for home care benefits has bipartisan backing in Congress. - **Atrium Health**: A healthcare system that has taken steps to alleviate medical debt for patients, reflecting broader trends in healthcare equity. ### Innovations, Trends, and Initiatives - **Drug Price Negotiation Program**: A program allowing Medicare to negotiate prices for the ten most expensive drugs, expected to reduce costs by 38% to 79%. - **DrugPriceNegotiationProgram**: Allows Medicare to negotiate prices for high-cost drugs, a significant policy shift aimed at reducing drug costs. - **Medicare Drug Price Negotiation Program**: Established under the Inflation Reduction Act, allowing the federal government to negotiate prices for selected drugs, with the first set of negotiated prices set to take effect in 2026. - **Value-Based Agreements**: Emerging strategies discussed to manage costs of expensive drugs, particularly in oncology and rare diseases. - **Market Power Utilization**: The U.S. government leveraging Medicare's market power to negotiate lower drug prices. - **Medicare Drug Price Negotiation Program (MDPNP)**: Established under the Inflation Reduction Act of 2022, allowing Medicare to negotiate prices for certain high-cost drugs, with the first negotiations set to take effect in 2026. - **Increased Transparency Initiatives**: The Trump administration plans to enhance transparency in Medicare drug price negotiations, responding to industry criticism. - **AI and Machine Learning**: Technologies being utilized by DCCA in the development of the MTF DM to facilitate timely drug price negotiations. - **InflationReductionAct**: Established the Medicare Drug Price Negotiation Program, projected to save Medicare $6 billion and provide $1.5 billion in out-of-pocket savings by 2026. - **Patient-Focused Roundtables**: CMS's initiative to include patient perspectives in the negotiation process to ensure that the needs of individuals reliant on medications are prioritized. - **Inflation Reduction Act**: Legislation allowing Medicare to negotiate drug prices for the first time, projected to save nearly $25 billion by 2031. - **Maximum Fair Price (MFP) Program**: A CMS initiative under the IRA to establish fair pricing for drugs, with negotiations expected to begin in early 2025. - **340B Drug Pricing Program**: A federal program that allows certain healthcare organizations to purchase drugs at discounted prices, facing legal disputes from major drugmakers. - **Inflation Reduction Act (IRA)**: Legislation that empowers CMS to negotiate drug prices, aiming to improve drug affordability and sustainability of the Medicare program. ### Challenges and Concerns - **Complexity of U.S. Drug Pricing**: Described as byzantine, leading to higher costs compared to other countries, with negotiations primarily handled by PBMs. - **Legal Challenges**: Numerous lawsuits against CMS regarding the drug price negotiation program, with claims that it disrupts the balance between innovation and affordability. - **Impact on Innovation**: Critics argue that price negotiations could stifle innovation in drug development and lead to delays in patient access to new therapies. - **Legal Challenges to Drug Price Negotiation**: Ongoing lawsuits from pharmaceutical companies challenging the legality of the IRA's provisions for drug price negotiations, citing concerns over federal power. - **Pharmaceutical Industry Concerns**: Pharmaceutical companies, including PhRMA, argue that price negotiations could hinder innovation and lead to bureaucratic challenges. - **PharmaceuticalIndustryResistance**: Concerns about the impact of drug price negotiations on innovation and profitability, leading to lobbying efforts to alter the Inflation Reduction Act. - **Pharmaceutical Industry Opposition**: Concerns from the industry that price negotiations may hinder innovation and drug development. - **Transparency Issues**: Concerns regarding the lack of transparency in drug pricing negotiations and the impact on consumer costs. - **Pharmaceutical Industry Lobbying**: Efforts by the pharmaceutical industry to delay or alter the negotiation timelines for drug prices, citing concerns over innovation. - **Cost-Related Non-Adherence**: Financial barriers leading to patients not adhering to asthma treatment, highlighting the need for further negotiations on drug prices. - **Legal Disputes**: Major drugmakers are engaged in legal battles over the 340B program, arguing for a rebate system to enhance program integrity. - **Impact on Independent Pharmacies**: Concerns have been raised about potential unfair reimbursements under the negotiation plan, particularly regarding the practices of pharmacy benefit managers (PBMs). - **Political Uncertainty**: The future of drug price negotiations may be influenced by upcoming elections and potential changes in administration, particularly regarding the IRA's provisions. - **Impact of Inflation Reduction Act**: Concerns raised about potential reimbursement cuts for oncology providers due to drug price negotiations. - **PoliticalUncertainty**: Potential changes in drug pricing policies under a new administration, particularly with Trump and Kennedy's influence.