Pharmacies Adapting to IRA-Negotiated Drug Prices Despite Looming Financial Concerns

At the start of 2026, pharmacies dispensing drugs under the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program (MDPNP) were required to have the proper systems in place by January 1. While the technical rollout of this program has been successful so far, experts believe financial consequences are almost certain for participating pharmacies in the near future.

“For context, we were really looking at 2 potential catastrophes at the same time,” Chad Worz, PharmD, BCGP, FASCP, executive director and CEO of the American Society of Consultant Pharmacists (ASCP), told Drug Topics. “One is related to the government-built data module and payment module that needed to be working January 1. The other was sort of a more predictive impact of the economic consequences of what IRA is doing to pharmacies.”

To help the Drug Topics audience get a better grasp on the MDPNP and the IRA’s industry-impacting provisions this year, Worz and his colleague—James Lewis, senior director of policy and advocacy at ASCP—discussed what pharmacies most likely experienced on January 1, 2026.

While they understand pharmacies’ ability to manage novel, administrative tasks common within the federal statute, Worz and Lewis expressed financial concerns stemming from this new program. Because the negotiations were designed to save both the federal government and patients money, pharmacies are essentially taking the brunt of the burden in making sure this program runs smoothly.

Get their insights on the day 1 reality of the MDPNP and stay tuned for more from our conversation with pharmacy industry and Medicare experts Worz and Lewis. “Anytime you're dealing with a significant change in your reimbursement structure, there's going to be hiccups and problems,” said Worz.

Read More: Pharmacy Owners Say They Are Unable to Participate in MDPNP

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