Liz Helms, Founder and Director of the Chronic Care Policy Alliance (CCPA), issued the following statement in response to the announcement of the list of medications subject to Medicare Drug Price Negotiations for IPAY 2028:
“The Chronic Care Policy Alliance (CCPA) has long supported policies that meaningfully lower prescription medication costs for people living with chronic conditions. These patients depend on consistent, uninterrupted access to medications and often face significantly higher out-of-pocket costs, making affordability essential to continuity of care.
“As two major milestones for the Medicare Drug Price Negotiation Program (MDPNP) converge, the program’s real-world impact on patients is only beginning to come into focus. At the start of 2026, the Maximum Fair Prices (MFPs) for the IPAY 2026 medications went into effect, while physician-administered Part B drugs are being selected for negotiation under IPAY 2028.
“While the program is intended to address prescription medication spending, policies must ultimately be measured by whether they improve patient access to care. Government-set prices do not guarantee lower out-of-pocket costs for patients. CMS itself has acknowledged that health plans may respond in ways that could undermine access and continuity of care, including formulary changes or increased utilization management.
“The inclusion of physician-administered therapies in the IPAY 2028 list raises serious concerns for physicians’ ability to deliver patient-centered care. Many practices are already stretched thin, and changes to reimbursement structures risk forcing providers to make decisions based on financial viability rather than clinical need. This dynamic risks disrupting patients’ access to consistent care, particularly those managing serious and chronic conditions.
“Patients have also expressed frustration with the lack of transparency around how their input meaningfully influenced negotiation outcomes. True patient engagement requires not only listening to patient perspectives but clearly demonstrating how those perspectives inform policy decisions throughout the process.
“While negotiated prices are intended to reduce Medicare spending and beneficiary costs, CCPA remains concerned that health plans and Pharmacy Benefit Managers (PBMs) may leverage utilization management tools, such as prior authorization, step therapy, or formulary exclusions, to retain savings rather than pass them on to patients.
CCPA remains committed to working with patients, policymakers, and federal agencies to ensure reforms are grounded in evidence and centered on patient experience. We urge policymakers to carefully monitor the real-world impact of the program on patients and ensure that their needs come before government cost reductions,” concluded Helms.