Medicare Drug Price Negotiation: ‘Spillover Effect’ on Private Market Remains Fuzzy

The Biden administration on Aug. 29 released its long-awaited list of the first 10 drugs that will be subject to price negotiation in the Medicare program, representing the first major step toward implementing the most ambitious drug-pricing reform in the Inflation Reduction Act (IRA).

While the new price-negotiation program will apply only to Medicare — not employer-based or individual market plans — industry experts say it will almost certainly affect the commercial insurance market indirectly. But they tell AIS Health, a division of MMIT, that exactly what the impact will look like hasn’t fully come into focus.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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