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Requires the Medicare & Medicaid Innovation Center (CMMI) to launch a five-year Most-Favored-Nation (MFN) drug pricing model starting January 1, 2029. Under the model, drug manufacturers that do not sign a covered agreement must offer defined Medicare and Medicaid beneficiaries—and the providers who dispense or administer drugs—an MFN price tied to the second-lowest adjusted net price among eight reference countries, and must supply pricing and sales data the Secretary of HHS requires. The law spells out how MFN prices are calculated, which drugs and beneficiaries are covered, a temporary suspension rule (through April 1, 2029) if a manufacturer is likely to sign an agreement, a deadline for covered agreements (December 31, 2028), and a five-year model period. It also requires reporting of covered agreements to congressional committees and imposes reporting and pricing obligations on manufacturers without a covered agreement.
The bill aims to lower drug prices and federal spending by tying U.S. prices to lower foreign benchmarks and incentivizing U.S. production, but it risks reduced drug availability, supply disruptions, slower innovation, and added administrative and legal costs.
Medicare Part B and Part D enrollees and Medicaid beneficiaries would pay lower prices for covered drugs because manufacturers must offer the MFN (most-favored-nation) price to eligible beneficiaries and providers.
Taxpayers and the federal budget could see reduced spending on Medicare and Medicaid drug benefits by tying U.S. prices to lower reference-country net prices.
Manufacturers that enter covered agreements and commit to increased U.S. production could expand domestic manufacturing, potentially strengthening supply chains and supporting U.S. jobs.
Patients, especially those with chronic conditions and Medicare beneficiaries, could face reduced access if some manufacturers limit U.S. supply, delay launches, or withhold drugs to avoid MFN pricing.
Hospitals and providers could experience shortages or greater acquisition complexity if manufacturers restrict distribution or opt not to offer products in the U.S.
Patients and the biomedical research community could see slower drug innovation over time if manufacturers expect reduced revenues in the U.S. market.
Introduced March 5, 2026 by Dan Meuser · Last progress March 5, 2026