Understanding the Effects of the Inflation Reduction Act on Medicare Part D Plans
In August 2022, the Inflation Reduction Act (IRA) was signed into law with the aim of providing significant financial relief to millions of Americans covered by Medicare. This legislation seeks to enhance benefits and reduce drug costs for the beneficiaries.1
Lingering Unanswered Questions
Nearly two years post its enactment, there are still uncertainties surrounding the implementation of certain provisions of the IRA, specifically the Medicare drug price negotiation program.
Insights from Industry Experts
Corey Ford, who serves as the Vice President of Reimbursement and Policy Insights at Cencora, has shed light on some aspects of the IRA. He mentioned that while clarity has been provided on data submission requirements for manufacturers and the structure of patient engagement sessions, there remains ambiguity on how to execute the manufacturer fair price.
Survey Results and Predictions
During the 2023 AMCP Nexus Meeting, Cencora employees shared the outcomes of a survey conducted among members of Cencora’s Managed Care Network (formerly Xcenda). Out of 50 respondents, 44% foresee a negative financial impact on Part D plans due to the IRA, while 34% anticipate a more limited effect. The survey also revealed expectations of narrower formulary design as a result of changes in Part D following the IRA.2
Future Outlook and Challenges
Looking ahead to the implications of the IRA, Ford hinted at data from 2024 indicating a potential preview of what might unfold in the subsequent year. The survey highlighted additional challenges such as heightened utilization management and reduced availability of Part D plans. Ford emphasized the importance of the 2024 data showing a 12% decrease in standalone drug plans, along with increased utilization management and premiums, offering insights into the potential scenario for 2025.
For more coverage from AXS24, where Ford discussed these findings, you can read the full conversation in Drug Topics by clicking here.
References
1. inflation reduction act of 2022. Department of Health and Human Services. Reviewed March 26, 2024. Accessed May 3, 2024. Available at: 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. Available at: https://www.ajmc.com/view/payers-expect-the-inflation-reduction-act-to-financially-impact-medicare-part-d-plans
Read More of this Story at www.drugtopics.com – 2024-05-03 18:18:39
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