Colchester Institute

January 1, 2026, marks the official start of Medicare directly negotiating prices for the first 10 high-impact medications. To manage this, a new entity called the Medicare Transaction Facilitator (MTF) has been established to handle the complex rebate and data exchange between pharmacies and manufacturers.

For pharmacies, this change brings significant financial pressure. Because reimbursement is now capped at the Maximum Fair Price (MFP) plus a modest dispensing fee, many retail pharmacies are struggling to cover their overhead. This document highlights the risk that some pharmacies may stop stocking these high-cost medications, potentially creating new access gaps for seniors in certain regions.