IQVIA data showed that Medicare-negotiated drug price cuts did not translate into immediate access improvements for many patients in early 2026. In the first quarter after maximum fair prices took effect on Jan. 1, 2026, nearly 24% of initial prescription attempts were rejected, with higher rates concentrated in immunology and oncology. The report cited large category gaps: immunology rejections were 59% and oncology 67%, versus 30% for diabetes and 21% for cardiovascular drugs. Even among those who initiated, 5% of patients remained unable to access prescribed medications 30 days later. The findings point to a key policy-to-practice mismatch: coverage on formularies does not ensure real-world dispensing when prior authorization, step therapy, and other utilization management tools persist.