Under the authority provided in the Inflation Reduction Act (IRA) of 2022, Medicare can now negotiate prices with drug manufacturers of selected single-source prescription drugs covered under Medicare Part B and Part D.
The goal of the program is to reduce costs for both the Medicare program and its beneficiaries. These negotiated prices, known as Maximum Fair Prices (MFPs), must be made available to eligible Medicare beneficiaries when they fill prescriptions under their Part D benefit at pharmacies and other dispensing outlets, or when they are administered or furnished a medication under Medicare Part B, such as an injectable or infused drug.
This white paper examines the issues and challenges associated with effectuation of Maximum Fair Prices for Medicare Part B drugs, including operational, reimbursement, and stakeholder considerations that may affect implementation across the healthcare system.
Read the full white paper to explore the policy context, emerging barriers, and key considerations for ensuring the successful application of MFPs in real-world Medicare Part B settings.