Navigating the current healthcare legislative landscape

Updates on the IRA’s Medicare Drug Price Negotiation Program

 

The Inflation Reduction Act’s Medicare Drug Price Negotiation Program  is one of the most significant pharmaceutical policy changes in decades. The program enables the Secretary of Health and Human Services to negotiate prices for certain high-expenditure drugs covered under Medicare Part D and, beginning in 2028, Medicare Part B.

• The first round of negotiated prices took effect January 1, 2026. That means maximum fair prices (MFPs) now apply to a select group of widely used Medicare Part D medications. This milestone introduces new administrative considerations around the dispensing and billing of MFP-eligible products.¹ 
• CMS recently announced the third round of negotiated drugs. On January 27, the Centers for Medicare and Medicaid Services released a list of 15 medications subject to Medicare price negotiation. On March 13, CMS announced that all manufacturers of drugs selected for the third round of negotiations have agreed to participate in the program. Following the negotiation phase, the MFPs for these 15 drugs will become effective January 1, 2028. This marks a significant expansion of the program because it includes Medicare Part B drugs for the first time.²
• Look for further clarifications on claims processing and program compliance. Although CMS issued its final guidance on effectuating MFPs in September, additional clarifications and guidance are likely as implementation continues.   We will continue to monitor for updates relevant to providers and healthcare stakeholders across the supply chain.³
  
  

The launch of TrumpRx

 

In February, the Trump administration launched TrumpRx, an online direct-to-consumer (DTC) platform that creates a pathway for consumers to buy discounted medications. The website is not intended to sell, dispense, or distribute drugs; rather, it functions as a centralized referral platform for consumers to search for their prescribed medications and, if included in the program, be redirected to the manufacturer’s DTC platform or be provided with a coupon. The launch of TrumpRx is part of the White House’s broader healthcare strategy, which includes increased access and visibility into prescription drug pricing.⁴

At this time, consumers can purchase 50+ drugs either directly from the manufacturer or with pharmacies. The platform also provides high-level information for prescribers and pharmacies.⁵

While the site remains in its early stages, users have pointed out that many of the available drugs have generic alternatives and patients who self-pay may see the most benefit when it comes to pricing.⁶ With that said, administration officials have indicated more drugs will be added  over time as the platform develops.⁷

Understanding CMMI’s MFN models

 

In addition to the IRA’s drug price negotiation program, the CMS Innovation Center (CMMI) has proposed several new models aimed at aligning U.S. drug prices more closely with those in other developed countries. These are commonly referred to as “most favored nation” pricing models.⁸ The following models are currently under consideration and take different approaches to benchmarking drug prices internationally:    

1. The Global Benchmark for Efficient Drug Pricing (GLOBE) model, which applies to Medicare Part B, aims to reduce price disparities between the U.S. and other developed nations. Under this model, U.S. physician-administered drug prices are compared to those in peer countries. Medicare payments could then be adjusted to align more closely with average prices in selected global markets. This is a five-year model that is anticipated to launch in October 2026 and run through 2031.⁹
2. The Guarding U.S. Medicare Against Rising Drug Costs (GUARD) model, which focuses on Part D drugs, is designed to help stabilize long-term Medicare spending. This model establishes guardrails to constrain retail price increases for certain high-cost drugs so that the net cost is comparable to what a group of economically similar countries pay. This model is expected to launch Janaury 2027 and run through December 2031.¹⁰
3. The Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) model is designed to increase access to select glucagon-like peptide-1 (GLP-1) medications and healthy lifestyle interventions for people with Medicare and Medicaid. Through this model, CMS can negotiate pricing and coverage terms with manufacturers of these medications. State Medicaid agencies can enroll in the model beginning in May 2026, and Medicare Part D plans beginning in January 2027.¹¹
4. The GENErating cost Reduction fOr U.S. Medicaid (GENEROUS) model, which applies to Medicaid only, aims to enable fair and reasonable drug prices in comparison to what other countries pay. Through negotiations between CMS and manufacturers, the model would establish supplemental rebates to be paid to participating states for the drugs included in the model. The model launched in January 2026 and will run for five years.¹²

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Cencora remains committed to strengthening supply chain resiliency and enabling healthier futures through a more efficient and effective healthcare landscape. Through our U.S. Public Policy and Advocacy team, we actively engage with U.S. policymakers and industry stakeholders to help shape policies that support patient access, operational stability, and sustainable innovation.

By advocating on behalf of customers and monitoring evolving regulatory developments, Cencora helps healthcare providers and pharmacies navigate a rapidly changing policy environment while continuing to deliver high-quality care to the communities you serve.

The information in this article is publicly available information and does not reflect any developments that may occur following March 23, 2026.  This article represents Cencora’s current understanding and interpretation of information related to the topics included in this article and is subject to change as new information becomes available. This article is not intended to communicate legal advice, direction, opinion, or guidance on behalf of Cencora, the U.S. government, or any entities that are mentioned herein.


References

1. Centers for Medicare & Medicaid Services, “Selected Drugs and Negotiated Prices,” February 27, 2026. 
2. Centers for Medicare & Medicaid Services, “CMS Announces Selection of Drugs for Third Cycle of Medicare Drug Price Negotiation Program, Including First-Ever Part B Drugs,” January 27, 2026. 
3. Centers for Medicare & Medicaid Services, “Medicare Drug Price Negotiation Program: Final Guidance, Implementation of Sections 1191 – 1198 of the Social Security Act for Initial Price Applicability Year 2028 and Manufacturer Effectuation of the Maximum Fair Price in 2026, 2027, and 2028,” September 30, 2025. 
4. The White House, “The Great Healthcare Plan,” January 2026. 
5. Megan Cerullo, “TrumpRx: See the 43 drugs available on the Trump administration's new discounted drug site,” CBS News, February 6, 2026. 
6. Kaye Pestaina, Michelle Long, and Justin Lo, “TrumpRx: What’s the Value for Customers?” KFF, February 24, 2026. 
7. Daniel Payne, “White House looks for more drug pricing deals to add to TrumpRx,” STAT, February 6, 2026. 
8. The White House, “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” May 12, 2025.
9. Centers for Medicare & Medicaid Services, “GLOBE (Global Benchmark for Efficient Drug Pricing) Model,” December 29, 2025.
10. Centers for Medicare & Medicaid Services, “GUARD (Guarding U.S. Medicare Against Rising Drug Costs) Model,” December 29, 2025.
11. Centers for Medicare & Medicaid Services, “BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model,” March 23, 2026.
12. Centers for Medicare & Medicaid Services, “GENEROUS (GENErating cost Reductions fOr U.S. Medicaid) Model,” March 2, 2026.