The US Supreme Court on Monday rejected a series of appeals from several of the nation’s largest drugmakers challenging a program that is expected to save taxpayers and the federal government billions of dollars by requiring the companies to negotiate with Medicare on the prices for some of their most popular drugs.

The court’s decision to deny the appeals, which it made without explanation, leaves in place several lower court rulings upholding the program that Congress enacted in 2022. Other lawsuits over the program are still pending.

At issue is a provision in the 2022 Inflation Reduction Act that allows Medicare to negotiate the prices of certain drugs for the first time after years of debate about whether such negotiation would effectively be government price fixing. Yet the rising cost of prescription drugs has added financial pressure on Medicare and its beneficiaries.

The drugmakers, including AstraZeneca and Janssen, said the program leads to a “sham negotiation” that violates their due process rights. Most also argued that the program violates the First Amendment because it compels them to “adopt the government’s narrative” of a negotiated agreement. Lower courts have rejected those arguments, noting that the companies are free to pull their products from government health programs.