The Inflation Reduction Act of 2022 (IRA) continues to reshape the landscape of prescription drug costs for millions of Americans on Medicare. Beyond the widely discussed price negotiations, a key component of the law is improving access to those same drugs. A recent analysis reveals that the IRA’s coverage requirement—mandating all Medicare Part D plans cover drugs selected for price negotiation—is already leading to expanded coverage, even before the negotiated prices take full effect in 2026 and 2027.
The Medicare Drug Price Negotiation Program, enacted as part of the IRA, allows the federal government to directly negotiate prices for some of the highest-cost drugs covered by Medicare. But the law goes further, requiring that all Medicare Part D plans include these selected drugs on their formularies, in all dosages and forms, once the negotiated prices are implemented. This coverage requirement is designed to ensure that beneficiaries can actually benefit from the lower prices. The analysis, examining 2026 coverage data, shows improvements in access to several drugs selected for negotiation, signaling a positive impact for Medicare enrollees.
Improved Coverage for First 10 Negotiated Drugs
As of January 1, 2026, Medicare-negotiated prices are available for the first 10 drugs selected for negotiation. The analysis found that coverage rates have improved since 2025 for several dosages and forms of nine out of these ten drugs. This means more Medicare beneficiaries now have access to these medications through their Part D plans. The most significant gains in coverage were seen with certain insulin products, Fiasp and NovoLog, and two dosages of the cancer drug Imbruvica.
In 2025, Fiasp was covered by just 24% of Part D plans, while NovoLog was covered by 32%. Coverage for two dosages of Imbruvica reached roughly half of Part D enrollees. The IRA’s coverage requirement is effectively leveling the playing field, ensuring broader access to these medications for those who need them.
Looking Ahead: Expanded Access with the Next Round of Negotiations
The benefits aren’t limited to the first 10 drugs. The IRA also selected 15 additional drugs for price negotiation, with those prices set to take effect in 2027. The analysis highlights the potential for further coverage improvements with this second round. One drug in particular, Wegovy, a GLP-1 receptor agonist used for obesity and cardiovascular disease risk reduction, currently has limited coverage in Part D plans—less than 1% of enrollees had access in 2026.
Currently, Medicare Part D plans are permitted to cover Wegovy only for cardiovascular disease, as Medicare is prohibited from covering drugs solely for weight loss. But, the Trump administration is planning a voluntary model to expand Medicare coverage of GLP-1s for obesity treatment beginning in 2027, potentially opening access to Wegovy for a wider range of beneficiaries. The Centers for Medicare & Medicaid Services (CMS) is developing this model to explore broader coverage options.
The IRA’s coverage requirement will also increase access to six other drugs selected for negotiation in 2027 that currently aren’t universally covered, including Austedo and Austedo XR (for involuntary movement disorders), Otezla (for psoriasis and psoriatic arthritis), and Breo Ellipta (for asthma and COPD). Several drugs already enjoy widespread coverage due to being part of Medicare’s “six protected classes”—Xtandi, Pomalyst, Ofev, Ibrance, and Calquence (antineoplastics) and Vraylar (an antipsychotic)—which all plans are required to cover.
The Inflation Reduction Act’s impact extends beyond simply lowering drug prices. By ensuring broader coverage of selected medications, the law is taking a significant step toward improving health equity and access to essential treatments for Medicare beneficiaries. As the negotiated prices take effect and more drugs are added to the program, the benefits are expected to grow, offering substantial relief to millions of Americans.
The next key date to watch is January 1, 2027, when the negotiated prices for the second set of 15 drugs will go into effect. CMS will continue to monitor coverage rates and assess the impact of the IRA on access to affordable medications. Further updates and information can be found on the CMS website.
Have thoughts on the impact of the Inflation Reduction Act? Share your comments below.
Related reading
