Drug Pricing Policy Updates & Impact
At The US Oncology Network, protecting patient access to community oncology is our top priority. As drug pricing proposals continue to emerge from Washington D.C., we track and analyze each initiative to ensure policymakers understand how these policies may affect cancer patients and the practices that serve them. Here you will find up-to-date information on the measures we are monitoring.
Executive Actions on Drug Pricing
Summary
In 2025, the Trump administration issued two executive orders focused on lowering drug costs. One directed HHS to issue guidance for IRA negotiations, improve PBM transparency, and review site-of-care payment policies. The other instructed agencies to develop strategies for achieving MFN pricing. Additionally, the administration advanced voluntary discount agreements with manufacturers and launched the TrumpRx direct-to-patient purchasing initiative, while a separate presidential memorandum strengthened oversight of prescription drug advertising.
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Most Favored Nation (MFN) Models
Summary
As a result of the 2025 executive order on drug pricing, CMMI advanced MFN strategies to align U.S. drug costs with international benchmarks. Instead of reducing provider reimbursement like the blocked 2020 model, CMMI adopted a manufacturer rebate approach, modifying the Medicare inflationary rebate formula without impacting ASP. Three new models—GLOBE (Part B), GUARD (Part D), and GENEROUS (Medicaid)—will test MFN-linked rebates and international price benchmarking to lower costs through global alignment.
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Inflation Reduction Act
Summary
The IRA authorizes Medicare to negotiate prices for high-cost drugs, beginning with Part D in 2026 and expanding to Part B in 2028. It also introduces a $2,000 annual cap on out-of-pocket costs, penalties for non-compliance, and Maximum Fair Price ceilings based on drug age, significantly impacting patient affordability and provider reimbursement.
340B Drug Pricing Program
Summary
The 340B Rebate Model Pilot proposed replacing upfront discounts with post-sale rebates but was halted by a court injunction citing APA violations. CMS will also conduct a hospital acquisition cost survey under OPPS to inform payment policy changes starting in CY 2027, aiming to improve transparency and align reimbursement with actual costs.