Medicare Drug Pricing

Wiley is uniquely positioned to help health insurers and drug manufacturers navigate the Medicare drug pricing landscape amid unprecedented shifts brought on by the Inflation Reduction Act of 2022 (IRA). The multidisciplinary team has extensive experience in all areas of drug pricing regulation – including negotiations with the Centers for Medicare & Medicaid Services (CMS) – and in representing companies of all sizes that do business directly with the federal government.

The firm’s combined health care and government contracts expertise makes Wiley a crucial advocate for any company with a stake in the IRA, which is designed to reduce health care costs by:

• Allowing Medicare to negotiate prices directly with drug manufacturers;
• Requiring drug companies to pay rebates if they raise their prices for certain Medicare Part B and Medicare Part D drugs faster than the rate of inflation; and
• Lowering out-of-pocket expenses for Medicare recipients.

As CMS implements the Medicare Drug Price Negotiation and Medicare Prescription Drug Inflation Rebate programs to effectuate the IRA’s goals, Wiley’s focused industry knowledge helps us anticipate challenges and create solutions that minimize risks to our clients’ businesses while maximizing potential benefits.

With a deep understanding of the new law and its ancillary programs, we closely monitor the unfolding IRA developments to provide sound advice on commercial market strategy and successfully navigate the rapidly evolving legal, regulatory, and business environment.