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On January 1, 2026, ten of the most widely used and expensive brand drugs in Medicare will be placed into their own acquisition and reimbursement system, known as the Medicare Drug Price Negotiation Program (MDPNP).
Recently, CMS created guidance for this program, which will ultimately result in a system where a pharmacy’s reimbursement for these ten drugs is capped at the acquisition cost of the drug, resulting in a maximum gross profit of zero dollars or worse. This could drive pharmacies out of Medicare altogether and severely undercut patients’ ability to receive the medications they need.
CMS’s Faculty Guidance
Pharmacy’s Max Profit Will Be…