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On Tuesday morning, the Department of Health and Human Services unveiled its long-awaited list of the 10 medicines that will be subject to price negotiation in 2026 under the Inflation Reduction Act.

This will mark the first time that Medicare, the government program for paying for health care for older Americans, will have any ability to use its vast size to negotiate for lower prices. It’s not yet clear how big the discounts on these 10 drugs will be, or even if the law will hold up to multiple legal challenges from the pharmaceutical industry. It’s also not clear, as critics from the drug industry have noted, whether any savings to the government will be passed on to consumers.

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Still, the naming of 10 medicines is a milestone, and a point to start appraising the impact of the law. The landscape here is complicated. No one really knows how the IRA’s price negotiation process will play out over the short and long term, and many companies who had products named were spared in other ways, with products many industry watchers expected to see on the list absent. Here is STAT’s assessment of who has won and lost.

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