CMS updates Medicare drug price negotiation guidelines

CMS published updated guidance for the Medicare Drug Price Negotiation program, based on feedback from more than 7,500 public comments. 

Advertisement

In a June 30 news release, the agency revised the guidance to “improve transparency and foster an effective negotiation process.” 

Updated changes include: 

  • Only considering active designations and approvals for drugs to be considered “orphan drugs” 
  • Allowing drug manufacturers to speak publicly about the negotiation process at their discretion 
  • Adding additional opportunities for drug manufacturers and the public to weigh in during the negotiation process

CMS will publish the list of the first 10 drugs selected to negotiate with the government for pricing on Sept. 1. 

The Inflation Reduction Act established Medicare’s authority to negotiate with drug manufacturers over the cost of medications. Negotiated prices for the first 10 drugs will take effect in 2026, eventually expanding to 60 drugs by 2029. 

The U.S. Chamber of Commerce, two drugmakers and three healthcare organizations have filed lawsuits challenging the drug price negotiations. 

Read the full updated guidance here.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Advertisement

Next Up in Policy Updates

Advertisement

Comments are closed.