New survey: Insurers confirm IRA will reduce patient treatment options

A recent survey conducted by Magnolia Market Access provides insight directly from insurers, revealing in no uncertain terms that insurers plan to restrict coverage in Part D because of the Inflation Reduction Act (IRA). When assessing the law, the negative impact it is having on access to medicines cannot be overlooked.

Here's what you should know:

• 89% of insurers plan to increase utilization management tools and pare down formularies
• 78% of insurers expect to create more stringent utilization management for new medicines
• 83% of insurers plan to increase the number of medicines excluded from their formularies
• 78% of insurers plan to decrease the number of therapeutic options in classes with medicines selected for price setting

A survey conducted by Clarivate Consulting Services had similar findings: Insurers are consistently clear that they plan to restrict access as the IRA changes are implemented. And we're already seeing it happen with fewer Part D plans being offered in 2024 than in previous years.

The IRA is just beginning to go into effect, but it is already resulting in significant unintended consequences for Medicare beneficiaries. Seniors could experience higher costs, fewer options and disruptions in their health care coverage because the IRA failed to rein in abusive insurer and PBM practices that limit patients' access to care.

Congress and the administration must act soon to address these issues and protect seniors' access to essential medicines.