Case study: How seniors could face access disruptions because of the IRA’s price setting provisions

For millions of seniors nationwide, the Inflation Reduction Act (IRA) is poised to create further uncertainty about what medicines they can access as part of their Medicare Part D plans. For example, one recent studylooked at two classes of medicines to treat diabetes and atrial fibrillation and found that at least 1.5 million Part D patients taking these medicines could see their access disrupted because of the IRA's price setting provisions.

As a result of the IRA's misguided government price setting policies, Part D plans may change their formulary and coverage rules to disadvantage medications selected for price setting. In other instances, plans may change their formulary and coverage rules to disadvantage a medicine notselected for price setting. The result: disrupted access to lifesaving medicines.

Learn more about how these changes impact the health of Lisa, Jeff, Carl and Stephanie here.

When the government gets in between patients and their medical providers, access to necessary treatments suffers. If policymakers don't act soon, the IRA will continue to create barriers for seniors, just like the patient scenarios above. Congress and the administration must protect seniors' access to essential medicines by reining in insurers and PBMs before they increase access barriers.