PIPC shared the following statement highlighting its appreciation for the Trump Administration’s goal of lowering health care costs for patients awhile sharing continued concerns over the subjectivity and lack of transparency in the process for selecting a Maximum Fair Price (MFP), limited consideration of patient perspectives, and potential for continued reliance on value assessments conducted by the Institute for Clinical and Economic Review.
The Partnership to Improve Patient Care (PIPC) appreciates the Trump Administration’s goal of lowering health care costs for patients and is eager to work together toward achieving this goal while maintaining patients’ access to needed treatments. However, we continue to have significant concerns over the subjectivity and lack of transparency in the process for selecting a Maximum Fair Price (MFP), limited consideration of patient perspectives, and potential for continued reliance on value assessments conducted by the Institute for Clinical and Economic Review. As the Administration pursues greater transparency in health care, we hope this extends to the decision-making in the Inflation Reduction Act’s Medicare Drug Price Negotiation Program. We look forward to learning more from the Center for Medicare and Medicaid Services (CMS) about the evidence base for the recently announced MFP decisions when the explanations are made public by March 2026.
Some of the evidence released as a part of the issuance of MFPs for Initial Price Applicability Year (IPAY) 2026 was concerning to PIPC. Several of the published MFP explanations referenced reports from the Institute for Clinical and Economic Review (ICER) and other value assessments using biased methodologies that inherently devalue people with disabilities, relying on measures that fail to recognize how people with disabilities and chronic conditions and their families value and perceive their quality of life and health improvement. These types of value assessments too often conflate all therapies for the same condition as equal therapeutic alternatives, when in fact they are not interchangeable among patients or equally effective for all patients.
PIPC members, representing a diverse, broad-based group of health care stakeholders, are dedicated to working together to advance policies giving a voice to patients, giving choice to patients, and advancing value for patients. We urge the administration to collaborate closely with patient and disability experts, who are eager to help the Trump Administration be successful in efforts to lower patient out-of-pocket costs. We also urge the administration to solicit patient input throughout the process of implementing MFPs to ensure the Medicare Drug Price Negotiation Program safeguards patient access to optimal care, shared decision-making between patients and providers, and continued medical progress, while also mitigating risks associated with utilization management strategies that may present barriers to care.
Some of the evidence released as a part of the issuance of MFPs for Initial Price Applicability Year (IPAY) 2026 was concerning to PIPC. Several of the published MFP explanations referenced reports from the Institute for Clinical and Economic Review (ICER) and other value assessments using biased methodologies that inherently devalue people with disabilities, relying on measures that fail to recognize how people with disabilities and chronic conditions and their families value and perceive their quality of life and health improvement. These types of value assessments too often conflate all therapies for the same condition as equal therapeutic alternatives, when in fact they are not interchangeable among patients or equally effective for all patients.
PIPC members, representing a diverse, broad-based group of health care stakeholders, are dedicated to working together to advance policies giving a voice to patients, giving choice to patients, and advancing value for patients. We urge the administration to collaborate closely with patient and disability experts, who are eager to help the Trump Administration be successful in efforts to lower patient out-of-pocket costs. We also urge the administration to solicit patient input throughout the process of implementing MFPs to ensure the Medicare Drug Price Negotiation Program safeguards patient access to optimal care, shared decision-making between patients and providers, and continued medical progress, while also mitigating risks associated with utilization management strategies that may present barriers to care.
