This week, ASHP, along with the National Pharmaceutical Association, the Hematology/Oncology Pharmacy Association, and 38 state pharmacy associations, urged the Centers for Medicare & Medicaid Services (CMS) to require drug manufacturers to provide upfront discounts under the Inflation Reduction Act (IRA). Our letter presses CMS to reject a rebate-based pricing model proposed by manufacturers, which would:
- Limit patient access to lower-cost medications
- Increase costs for pharmacies and providers
- Undermine the goals of the IRA and the president’s executive order on drug pricing transparency
Instead, ASHP and our partners recommend that CMS require manufacturers to honor the maximum fair price through an upfront discount — a move that would reduce administrative burden, improve price transparency, and support provider sustainability.
“The rebate framework will force pharmacies and hospitals to pay high prices when they stock drugs for Medicare patients. We should follow a commonsense approach of requiring manufacturers to sell at the negotiated price up front,” said Tom Kraus, ASHP vice president of government relations. “We fully support the IRA’s goals and we look forward to working with CMS to find a solution that doesn’t threaten the ability of patients to access lower-cost medications.”
The letter follows a meeting with CMS officials in March 2025 and previous joint letters from national pharmacy organizations and health systems to CMS outlining issues with the proposed IRA framework.
ASHP will continue to advocate for policies that ensure patients have access to critical medications.
