Video: The Inflation Reduction Act in 2024 and Beyond

Since being signed into law in August 2022, the Inflation Reduction Act (IRA) is intended to provide “meaningful financial relief” for millions of Americans with Medicare coverage, through expanded benefits and lowered drug costs.¹ Nearly 2 years after its passing, though, unanswered questions around how provisions of the IRA—in particular, the Medicare drug price negotiation program.

According to Corey Ford, Vice President of Reimbursement and Policy Insights at Cencora, stakeholders have been provided clarity around data submission that manufacturers must provide, as well as on what patient engagement sessions will look like. “But there’s really a lack of clarity right now on how to operationalize the manufacturer fair price,” he explained.

At the 2023 AMCP Nexus Meeting, Cencora employees presented the results of a survey administered to members of Cencora’s Managed Care Network (formerly Xcenda).² Among the 50 participants who responded, 44% predicted that the IRA would have an adverse financial impact on Part D plans, whereas 34% expected a more limited financial impact. Respondents also indicated that they anticipate the changes to Part D resulting from the IRA will lead to either somewhat (52%) or significantly (24%) narrower formulary design.²

Looking toward the future of the IRA, “I think we have some data in 2024 that is really showing to be a harbinger for what we could see next year,” Ford explained. Additional challenges from the survey included higher utilization management and less Part D plan availability. “2024 gives us real data,” Ford said. “And what we’ve seen is [approximately] a 12% reduction in the total number of standalone drug plans,” as well as higher utilization management and higher premiums.

“That is something that I think is going to tell us what 2025 could look like as well,” he said.

Ford sat down with Drug Topics at AXS24, the Asembia Specialty Pharmacy Summit, held April 28 to May 2 in Las Vegas, Nevada. Click here for more of our coverage from AXS24.

References

1. Inflation Reduction Act of 2022. Department of Health and Human Services. Reviewed March 26, 2024. Accessed May 3, 2024. https://www.hhs.gov/inflation-reduction-act/index.html

2. McCormick B. How payers expect the IRA to financially impact Medicare Part D plans. AJMC. October 24, 2023. Accessed May 3, 2024. https://www.ajmc.com/view/payers-expect-the-inflation-reduction-act-to-financially-impact-medicare-part-d-plans