Supporting Manufacturers Through CMS Drug Price Negotiations
The US Government introduced a new policy framework requiring CMS to negotiate drug prices for selected Medicare products. For manufacturers, this represented an unprecedented shift in the pricing lifecycle, bringing formal government negotiation into assets that were already established in market.
Verpora supported several medium and large US manufacturers across a nine-month process, working alongside newly formed senior negotiation teams and in partnership with a Washington-based law firm, Manatt Health.
The Challenge
CMS negotiations were taking place at a stage of the product lifecycle where formal price defence of this kind had no precedent. Many teams had limited recent experience defending brand value in structured, high-intensity negotiation settings.
The commercial implications extended beyond the negotiated Maximum Fair Price itself, with potential ripple effects across reference pricing, commercial contracts and global markets. Teams needed to defend value under scrutiny, anticipate CMS positions, and operate effectively in a high-pressure, politically visible environment.
Verpora Approach
Verpora provided strategic and tactical support from initial submission through to final face-to-face negotiations. This included clinical and health technology assessment analysis, preparation of pricing arguments, modelling of real-world data relevance for the Medicare population, and structured development of negotiation strategy.
Senior teams were prepared through mock negotiations and pressure testing of anticipated CMS moves. Human performance expertise was integrated throughout, supporting leadership alignment, message discipline and resilience across each stage of the process.
Client Impact
Clients entered negotiation with clear strategic positioning, structured concession pathways and defined anchor strategies. Senior teams operated with greater confidence and consistency across submissions, MLS responses and face-to-face meetings.
Manufacturers also developed a documented roadmap of the negotiation process, enabling wider internal learning and application across other assets and markets. Insights gained from early negotiation rounds strengthened preparedness for future CMS cycles and informed broader pricing strategy.
“The Verpora team input to the CMS drug price negotiations was outstanding; I would prefer to negotiate against CMS than against Omar!”
Head of US Contract Portfolio Strategy
Key Takeaway
CMS drug price negotiation represents a structural change in the US pricing environment. The implications extend beyond individual brands to future launch planning, portfolio management and global reference pricing dynamics.
Early participation has provided manufacturers with rare insight into the mechanics, expectations and pressures of the process. Structured preparation and disciplined execution are increasingly critical in protecting long-term portfolio value under this new framework.
