MRK · 10-Q · 2026Q3 · Full report

Pricing and Market Access

Merck & Co., Inc. · 2026-11-04 · Importance 46 · Surprise 42 · In source text

Merck reported that the government-set Medicare price for Januvia took effect on January 1, 2026, while negotiated prices for Janumet and Janumet XR are scheduled to take effect January 1, 2027. The company said the German GKV-BStabG, approved in July 2026, will exert significant downward pressure on revenues in Germany, particularly for Keytruda, with most provisions taking effect January 1, 2027. Under its three-year U.S. government agreement announced in December 2025, Merck provides Januvia, Janumet and Janumet XR through a direct-to-patient program and agreed to discounted Medicaid pricing for existing medicines, subject to exceptions. Merck also agreed to participate in the GENEROUS Medicaid model and expects that participation to exempt it from the mandatory GLOBE Medicare Part B model through December 2030.

Key facts

• The IRA's Medicare Part D government price setting took effect in 2026; Medicare Part B price setting starts in 2028. source
• The government-set price for Januvia became effective January 1, 2026; set prices for Janumet and Janumet XR become effective January 1, 2027. source
• HHS selected Lenvima for government price setting in January 2026, with the set price effective January 1, 2028. source
• Merck expects Keytruda to be selected for government price setting in 2027, effective January 1, 2029; a pending CMS proposed rule may subject Keytruda Qlex to price setting at the same time. source
• Merck says government price setting may negatively affect its private-market pricing and performance. source
• Merck anticipates health-care cost-containment actions will continue to negatively affect sales and profits. source
• Merck says increased use of the 340B program and restrictions on its ability to identify inappropriate discounts are negatively affecting company performance. source

Impact estimates