The Future of Market Access (Series): Impact of the Inflation Reduction Act

The introduction and passage of the Inflation Reduction Act of 2022 (IRA) was a paradigm shift in the approach that the Centers for Medicare & Medicaid Services (CMS) takes to drug pricing and reimbursement within the Medicare channel. CMS was tasked with establishing a program to negotiate maximum fair prices (MFPs) for certain high-expenditure, single-source drugs covered by Medicare. To date, the agency has selected 25 products for price negotiation, with MFPs scheduled to go into effect in 2026 for 10 of those products and in 2027 for the remaining 15.

Manufacturers will need to watch how pricing and market access dynamics evolve in Medicare and commercial managed care vis-à-vis the setting of MFPs for Part D products and determine implications for their portfolio. To understand the scope of the impact this law is likely to have on the market access landscape, SciVida conducted interviews with executives from leading managed care organizations and pharmacy benefit managers to get their perspective on the IRA and other topics that will shape the future of market access.

In this white paper, we detail the views these managed care executives shared on the potential impacts of the IRA and the establishment of MFPs. (March 2025)