The Medicare drug-price negotiation program of the Inflation Reduction Act is in full implementation. CMS issued initial guidance in March 2023, detailing the process for drug selection, exemptions, and the negotiation process. The final guidance document (released in summer 2023), was followed in September 2023 by the first list of 10 Medicare Part D products selected for the program. Some drug manufacturers have established internal teams to prepare for collecting data and generating evidence in anticipation of the negotiation process. Others are struggling to understand the implications of the Medicare negotiation program and concurrent Medicare and Medicaid pricing reforms. A multistakeholder panel will separate facts from fiction in the drug-price negotiation program, review the initial list of drugs up for negotiation, suggest how manufacturers can prepare for the program along with concurrent Medicare pricing reforms, and look ahead to how CMS can safeguard against unintended consequences of drug innovation.