Medicare Drug Price Negotiation Opportunities and Resources

Thank you for participating in our Healthy Aging with HIV Series Certificate Program and for the care you provide to older adults living with HIV. Many of you serve as prescribers, care coordinators, and navigators, managing complex Medicare coverage realities every day.

The Centers for Medicare & Medicaid Services (CMS) has announced the selection of a widely used HIV treatment for Medicare price negotiation under IPAY2028 as part of the Inflation Reduction Act (IRA).

For our community, this issue is not abstract.

Medicare negotiation has potential implications for formulary design, care coordination and workflows, administrative burden, and treatment continuity–particularly for older adults managing multiple chronic conditions. As CMS gathers clinical and patient input, perspectives from providers actively delivering HIV care will be especially important. Stable access to long-term HIV treatment directly affects medication adherence, overall quality of life, and how “unmet medical need”—as well as real-world implementation challenges—are understood during negotiations.

This is a critical time to share your experience.

Here’s What You Need to Know Now:

2028 IPAY Medicare Drug Price Negotiation Program public engagement process: CMS is negotiating prices for 15 drugs and is inviting patients, advocates, and providers to share real-world experience with these medications. Input from people affected by HIV—and those who care for them—can directly inform these negotiations.

The links below provide practical tools to help you prepare, understand, and make the most of these opportunities.

• When Cost-Cutting Undermines HIV Care—The Case for Single-Tablet Regimens
  Op-Ed in PositivelyAware, April 21, 2026
• National Health Council IPAY 2028 Patient and Provider Toolkit
  Overview of IPAY 2028, including an op-ed, written comments, and a communications toolkit.
• CMS Town Hall Meeting on Biktarvy Price Negotiations: Comments by Joseph Cherabie
  Comments provided by Joseph Cherabie, MD, MSc, HIV Medicine Association, Board of Directors, during the Centers for Medicare and Medicaid Services Town Hall Meeting on Biktarvy Price Negotiations, April 22, 2026.
• CMS Town Hall Meeting on Biktarvy Price Negotiations: Comments by Kevin Herwig
  Comments provided by Kevin Herwig, HIV+Hepatitis Policy Institute, during the Centers for Medicare and Medicaid Services Town Hall Meeting on Biktarvy Price Negotiations, April 22, 2026.