On Demand Webinar: Navigating the challenges of the IRA’s Maximum Fair Price (MFP)…are you ready for 2025? 

Thank you to everyone who joined us for our Lunch & Learn webinar, “Navigating the challenges of the IRA’s Maximum Fair Price (MFP)…are you ready for 2025? ,” presented by Avalere. The recording of this presentation is available on-demand at the member portal.

Beginning January 2026, drugs selected by CMS as subject to a “Maximum Fair Price” (MFP) will begin effect. In effectuating the MFP, claims for selected drugs will likely be paid at MFP at the point of sale. Under this model, pharmacies will likely carry a negative balance between their WAC based purchase price and the MFP payment. Under this model, the manufacturer itself (or through a contracted third party) will be required to issue a direct transfer of funds to the dispensing entity as the “MFP refund.

There are several outstanding items that have not been addressed from a pharmacy perspective, including (a) potential cash flow challenges during the MFP refund waiting period, (b) the timing of MFP refund, once a manufacturer receives notification that a negotiated drug was dispensed to a Medicare beneficiary, (c) 340B duplicate discount liability under a contract pharmacy agreement, and (d) concerns that the standard MFP refund is enough to address gross profit erosion.

During this webinar, speaker Clay Keene​​​​, Principal at Avalere, and Brook Getachew, Consultant on Avalere’s Policy team, will review the proposed flow of data and funds for the MFP effectuation, areas of concern and things to consider as part of mitigation planning.

These recordings are a benefit of NASP membership and designed to enhance and increase participants’ knowledge. Not a member? Join today!