IRA Drug Price Negotiations Threatening Pharmacies’ Financial Sustainability

Throughout the 21st century, health policy and legislation impacting American patients has been a controversial topic of discussion both within health care arenas and outside of them. With the Affordable Care Act (ACA) being one of those debated-upon statutes, the Inflation Reduction Act (IRA) of 2022 later built on the ACA, extending into 2026 and beyond, among other provisions.¹

Today, the IRA’s provisions are impacting pharmacy businesses and making their potential for financial sustainability a significant challenge. Now, with new and required Medicare drug pricing for the pharmacies that dispense Part D drugs—known as the Medicare Drug Price Negotiation Program (MDPNP)—experts in pharmacy and the businesses themselves have raised a multitude of concerns.

“Implementing the IRA is being born by pharmacies,” James Lewis, senior director of policy & advocacy at the American Society of Consultant Pharmacists (ASCP), told Drug Topics. “And unfortunately, both Congress and CMS, when given the chance to not do it this way, chose that pharmacy continues to be the unintended victim and payer of this entire program. Even if it's just in float, there's a huge opportunity cost to losing that funding.”

Lewis, along with ASCP Executive Director and CEO Chad Worz, PharmD, BCGP, FASCP, joined this week’s episode of Over the Counter to help the Drug Topics audience better understand how to meander the new IRA provisions. From a potential 21-day window of reduced cashflow in pharmacies to the potential for greater insurance-based red tape in the future, they explored the current state of the industry based on this sweeping legislation.

Stay tuned for weekly podcast episodes of Over the Counter powered by Drug Topics. Check out our most recent episode with Meagan Brown, PharmD, BCACP, who discussed pharmacists championing for provider status in celebration of National Pharmacist Day.

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REFERENCE

1. Ortaliza J, Cord A, McGough M, et al. Inflation Reduction Act health insurance subsidies: What is their impact and what would happen if they expire? KFF. July 26, 2024. Accessed January 22, 2026. https://www.kff.org/affordable-care-act/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/