Federal policymakers are moving aggressively on prescription drug pricing in 2026, with activity spanning IRA implementation, new CMS Innovation Center models, and direct action from the Trump administration. Medicare drug price negotiation is expanding, most favored nation pricing is reemerging through models like GLOBE and GUARD, and new initiatives such as TrumpRx and GLP-1 coverage demonstrations are testing how far the government can go to lower costs.
These policies have the potential to reshape reimbursement, formulary design, patient access, and site-of-care economics – particularly for high-cost drugs under Part B and Part D. With some policies already in effect and others poised to last beyond the current administration, stakeholders should assess where financial risk, operational complexity, and strategic opportunity will shift next.
