The Inflation Reduction Act implemented a regulation allowing price negotiation in the Medicare program to lower the cost of prescription drugs and to increase transparency. Section 1195 of the Inflation Reduction Act “penalizes any manufacturer of a selected drug that has entered into an agreement under §1193, with respect to a year during the price applicability period with respect to such drug, that does not provide access to a price that is equal to or less than the maximum fair price for such drug for such year.” With no prior federal regulation in place to deter price gouging, the new regulation establishes a pathway for negotiating lower prescription drugs supplied in the Medicare program, increasing access to care. Recently, the Centers for Medicare Services identified the first 10 drugs supplied through the Medicare program selected for initial price applicability in 2026. These drugs are common drugs you would see listed on the Medicare Part D drug list ranging from insulin to drugs to treat heart failure. CMS selected these drugs based on some of the following criteria (1) drugs for which there is no generic offered after 11 years of FDA approval and (2) drugs with the highest total gross covered prescription costs. In response to this new legislation, there are pending lawsuits filed by pharmaceutical companies claiming constitutional protection and perceived harm to consumers for creating an anti-competitive market. The challenges will be difficult to defend in light of public opinion because the new regulation is an improvement to the Part D drug program offering seniors lower drug prices.