Navigating the Shift: 2026 Medicare Drug Pricing and the Future of Pharmacy

Moving into 2026, the Inflation Reduction Act (IRA) is officially shifting from a legislative policy to a daily reality for pharmacists. For the first time, negotiated Maximum Fair Prices (MFPs) have taken effect for 10 high-spend Medicare Part D drugs, including critical medications like Eliquis, Jardiance, and Januvia. This landmark change marks a fundamental pivot for pharmacy businesses, transitioning the industry from traditional dispensing models to a new era of active financial navigation.

The introduction of these negotiated prices has brought about a significant operational shift. To facilitate these new fair prices, the government has established the Medicare Transaction Facilitator (MTF), a centralized technology platform managed by the Centers for Medicare & Medicaid Services (CMS). This infrastructure acts as the essential link between manufacturers, pharmacies, and Medicare Part D plans—managing what is known as the "effectuation" of drug prices.

Beyond the balance sheets, leaders in the field are raising concerns about the impact on patient care.

Chad Worz, PharmD, BCGP, FASCP, executive director and chief executive officer at the American Society of Consultant Pharmacists (ASCP), notes that as pharmacy becomes more focused on managing the books, there is a risk of losing the core focus on health care. In this video, Worz is joined by his colleague, James Lewis, senior director of policy and advocacy at ASCP, to discuss the ins and outs of the IRA’s 2026 provisions and how pharmacy businesses are scrambling to make do with a novel system of operations.

This transition represents one of the most significant changes to the pharmacy industry in recent memory. Understanding the mechanics of the MTF, the timeline of the refund process, and the clinical implication for patients is essential for every pharmacy professional working behind the counter.

Watch the full video to dive deeper into these 2026 updates and hear more from industry experts on how to successfully navigate these new provisions as more are set to take effect in the coming years.

READ MORE: IRA Drug Price Negotiations Threatening Pharmacies’ Financial Sustainability

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