New IQVIA analysis reports that Medicare drug price cuts tied to the 2026 negotiation program did not automatically translate into patient access. In the first quarter of 2026, nearly a quarter of patients attempting to fill prescriptions faced initial rejections, including high rejection rates for immunology and oncology drugs. The data looked at the first 10 negotiated drugs after maximum fair prices took effect on January 1, 2026, while noting that Part D formularies include the medications even when coverage does not guarantee access. Prior authorization, step therapy, and other utilization management tools appear to continue blocking timely fills. The report recommends ongoing monitoring of patient access metrics—not only government savings—highlighting how access barriers at the pharmacy counter can persist even under headline pricing reforms.