The Medicare Drug Price Negotiation Program (MDPNP) is a part of the Inflation Reduction Act (IRA) that sets maximum prices for 10 Medicare Part D-covered drugs for 2026, 15 drugs for 2027, and more drugs (including Part B drugs) beginning in 2028. This program will have significant impacts on pharmacy reimbursement and cash flow models. 

Pharmacies are not required by CMS to dispense MDPNP drugs, but individual PBM network agreements may require their dispensing. It is critical that pharmacies read their PBM contracts closely to ensure compliance. Many PBMs are also requiring enrollment into the Medicare Transaction Facilitator (MTF). For more information, click here.

Looking for information about the Medicare Prescription Payment Plan (also part of the IRA)? Check out this awesome summary from our friends at the Pharmacy Society of Wisconsin!