The Inflation Reduction Act (IRA), signed in 2022, gave Medicare the authority to negotiate the price of its highest-spend prescription drugs for the first time. Through the Medicare Drug Price Negotiation Program, the Centers for Medicare & Medicaid Services (CMS) sets a Maximum Fair Price (MFP) for each selected drug — a ceiling on what Medicare and its beneficiaries pay — phased in over annual cycles beginning in 2026.
The table lists each cycle's drugs and their MFP, sorted by Medicare spending. Those also flagged for a state Prescription Drug Affordability Board (PDAB) review could face a second price control atop the federal one.
| Drug | Manufacturer | Therapeutic Area | Medicare Spend | MFP | MFP Discount | PDAB State |
|---|
MFP = Medicare Maximum Fair Price, per 30-day supply. MFP Discount is the resulting cut off the drug's list price. Cycle 3 prices and discounts are pending — negotiation concludes in 2027.
Medicare Spend = approximate annual Medicare gross spend on the drug in the CMS drug-selection window ($ billions). CMS selects each cycle's drugs from its highest-spend Part D drugs (Part B added in Cycle 3); the table is sorted by that spend, highest first.
The PDAB State column lists U.S. states whose Prescription Drug Affordability Board is reviewing the drug — a state price control that would layer on top of the federal MFP. PDAB + UPL states can set a binding Upper Payment Limit; PDAB only states review affordability but cannot cap the price.