Drugmakers Already Offer Big Rebates for Some Meds Likely to Face Medicare Negotiation

More than half of the drugs that could be subject to Medicare price negotiations in 2026 already have net prices that are lower than the minimum discounted price established by the Inflation Reduction Act (IRA), according to an analysis published this month in the Journal of Managed Care + Specialty Pharmacy. The findings come as multiple pharmaceutical manufacturers file lawsuits challenging the IRA and as CMS is set to announce by Sept. 1 the 10 drugs that Medicare will negotiate prices for starting in 2026.

The IRA stipulates that until 2030 the negotiated price will be capped at the greater of the net price after rebates or a maximum percentage of the drug’s list price based on how long it has been on the market. Specifically, that maximum will be 75% of the average manufacturer price (or a minimum 25% discount) for drugs that have been marketed between nine and 16 years and 40% of the average manufacturer price (or a minimum 60% discount) for drugs that have been on the market for more than 16 years.

© 2024 MMIT
Tim Casey

Tim Casey

Tim has worked as a reporter and editor for more than 20 years. Before joining AIS Health in December 2021, he was a business reporter covering the commercial real estate industry’s capital markets for four years. He previously covered health care business issues for two medical publishing companies and high school, college and professional sports for the Sacramento Bee newspaper. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.

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