In this episode of Healthcare Matters, Dr. Robert Popovian and co-host Angela Degrassi examine the Inflation Reduction Act’s Medicare Drug Price Negotiation Program and whether lower prices negotiated by the government are translating into meaningful savings for patients at the pharmacy counter.

The conversation explains that the Inflation Reduction Act included several important changes for Medicare beneficiaries, including an annual cap on Medicare Part D out-of-pocket spending, the elimination of cost sharing for vaccines covered under Part D, and the introduction of government-negotiated maximum fair prices for selected medicines. Dr. Popovian emphasizes, however, that the maximum fair price determines what Medicare plans pay, not necessarily what patients pay.

The episode also discusses research from Pioneer Institute using real-world prescription data from the four largest pharmacy benefit managers, which together account for approximately 85% of the Medicare Part D market. The research tracks what patients paid for 24 non-insulin medicines selected for the first two rounds of negotiation, as well as how frequently prescriptions were filled with no out-of-pocket cost.

The findings show a complicated and uneven picture. From 2024 to 2025, patients paid more for 14 of the 24 medicines studied and less for ten, although the number of prescriptions filled at no cost increased because of the new out-of-pocket cap. During the first quarter of 2026, patients paid less for eight of the first nine negotiated medicines than in the same period in 2025, but several remained more expensive than in 2024.

Robert and Angela also discuss why lower negotiated prices may not produce equivalent reductions in patient costs. Benefit design, manufacturer price reductions, generic and biosimilar competition, premiums, deductibles, formulary tiers, prior authorization, and step therapy can all affect what patients ultimately pay and whether they can access their medicines.

The key message: lower government-negotiated prices should not be confused with lower patient out-of-pocket costs. Some provisions of the Inflation Reduction Act clearly help patients, but the ultimate test is whether Medicare beneficiaries pay less overall and can still obtain the medicines they need.

Pioneer Institute Study: https://pioneerinstitute.org/the-inflation-reduction-act/

Comments by Pioneer Institute to CMS: https://www.regulations.gov/comment/CMS-2026-2080-0019

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Angela Degrassi, Senior Manager, Patient-Centered Research Operations & Engagement: adegrassi@ghlf.org

A podcast series produced by Amelia Violet Prouse.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and co-host Angela Degrassi discuss the 340B Drug Discount Program and why a program created to help vulnerable patients has become an important issue for patient access, hospital transparency, and accountability.

The conversation explains how 340B allows eligible hospitals and other covered entities to purchase certain outpatient medicines at steep discounts. The original purpose was to help safety-net providers stretch limited resources and support uninsured, underinsured, and underserved patients. Dr. Popovian emphasizes that the program is valuable and should not be eliminated but asks whether the savings are actually reaching patients directly.

The episode also explores why many patients may not know they are receiving care at a 340B hospital, even though that hospital may be purchasing outpatient medicines at a significant discount. Patients are not automatically guaranteed to receive that discounted price, and hospitals are not clearly required to pass those savings directly to them.

Robert and Angela also discuss findings from a study Dr. Popovian co-authored comparing 340B and non-340B hospitals. The study found that 340B hospitals, on average, provided less charity care, less charity care for uninsured patients, and less uncompensated or unreimbursed care as a percentage of operating expenses than non-340B hospitals.

The key message: 340B was created to help vulnerable patients, but patients are often not told when hospitals receive these discounts and are not guaranteed to benefit directly. Patients should be informed, hospitals should be transparent, and there should be a clear pathway for patients to ask whether 340B discounts can help reduce their out-of-pocket drug costs.

Read the study here: https://www.medrxiv.org/content/10.64898/2026.02.12.26346191v1

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Angela Degrassi, Senior Manager, Patient-Centered Research Operations & Engagement: adegrassi@ghlf.org

A podcast series produced by Amelia Violet Prouse.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and co-host Angela Degrassi discuss why uncertainty surrounding the CDC’s Advisory Committee on Immunization Practices, known as ACIP, matters far beyond Washington, DC.

The conversation explains how ACIP recommendations are connected to the real-world systems that help patients get vaccinated, including pharmacist authority, state scope-of-practice laws, and Medicaid reimbursement. Dr. Popovian explains that adult vaccination is especially vulnerable to disruption because most adults receive vaccines at pharmacies, and in many states, pharmacists’ ability to administer vaccines is tied to ACIP recommendations.

The episode also explores why seasonal vaccines, such as flu and COVID vaccines, are particularly exposed to uncertainty because they require updated authorization and recommendations each year. Robert and Angela discuss what happened when COVID vaccine guidance was delayed, how some states responded with temporary workarounds, and why not every state may be prepared to act quickly if similar uncertainty continues.

The discussion also highlights GHLF’s new integration of Walgreens’ Vaccine Scheduler into GHLF’s vaccine hub, a tool designed to help adult patients better understand and access vaccines at local pharmacies.

The key message: ACIP may sound like an advisory body, but its recommendations can directly affect whether patients can get vaccines, whether pharmacists can provide them, and whether Medicaid will pay for them.

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Angela Degrassi, Senior Manager, Patient-Centered Research Operations & Engagement: adegrassi@ghlf.org

A podcast series produced by Amelia Violet Prouse.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.