16/08/2024 | News release | Distributed by Public on 16/08/2024 22:47
Yesterday, the administration released the government-set prices for the first 10 medicines selected under the Inflation Reduction Act (IRA). The announcement left out important context about what is already happening in Medicare Part D because of the changes in the IRA and how Medicare patients are negatively impacted.
As PhRMA President and CEO Steve Ubl stated: "The administration is using the IRA's price-setting scheme to drive political headlines, but patients will be disappointed when they find out what it means for them. There are no assurances patients will see lower out-of-pocket costs because the law did nothing to rein in abuses by insurance companies and PBMs who ultimately decide what medicines are covered and what patients pay at the pharmacy. The ironically named Inflation Reduction Act is a bad deal being forced on American patients: higher costs, more frustrating insurance denials and fewer treatments and cures for our loved ones." His full statement can be read here.
Even before the government-set prices were released, seniors and people with disabilities were facing increased access barriers in Part D because of how insurers are adapting to the law.
These concerning changes were left out of the administration's announcement, as were these key facts:
Looking at the Part D benefit designs that patients are actually enrolled in, actuaries predict that millions of Medicare patients will see higher out-of-pocket costs for medicines selected for government price setting.This analysis from Milliman found the IRA's drug pricing provisions could increase out-of-pocket costs for 3.5 million Part D patients taking a medicine subject to a government-set price in 2026, with low-income subsidy recipients, retirees, and Black and Asian beneficiaries seeing the largest increases.
Today marks the two-year anniversary of the Inflation Reduction Act being signed into law, and it's concerning how many unintended consequences have come to light. Policymakers must mitigate the harms of the IRA's price setting process and address the real barriers to patient access and affordability.