Most Favored Patient Act of 2026

This bill amends the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model that implements most-favored-nation drug pricing, starting January 1, 2029. Sec. 2, Requiring the Center for Medicare and Medicaid Innovation to test a model implementing most favored nation drug pricing: This section adds a new subsection (h) to the Social Security Act, which establishes the Most Favored Nations Pricing Model. Under this model, each specified manufacturer must provide access to the most-favored-nation price of each covered drug to eligible individuals and report necessary information to the Secretary. The Secretary may suspend these requirements until April 1, 2029, if the manufacturer is likely to enter into a covered agreement before that date. The model will last for 5 years. The section defines key terms: 'applicable net price' is the average price paid in a reference country adjusted for purchasing power; 'covered agreement' is an agreement where a manufacturer provides most-favored-nation pricing, reports information, and commits to increasing U.S. manufacturing; 'covered drug' is a specified drug sold in 2 or more reference countries; 'most-favored-nation price' is the second-lowest applicable net price; 'most-favored-nation price eligible individual' includes those eligible for Medicaid or enrolled in Medicare Part D or Part B; 'reference country' includes Canada, Denmark, France, Germany, Italy, Japan, Switzerland, and the United Kingdom; 'specified drug' includes covered outpatient drugs, Part B drugs, and Part D drugs; and 'specified manufacturer' is a manufacturer without a covered agreement.