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 study looked 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 not selected for price setting. The result: disrupted access to lifesaving medicines.
Four case studies illustrate the impact of scenarios that American seniors may face due to the IRA’s short-sighted price setting:
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.
Nicole Longo
Nicole Longo is Deputy Vice President of public affairs at PhRMA focusing on Medicare, 340B, importation and more. She previously worked for a D.C.-based public affairs firm where she assisted a wide range of clients with communications efforts on everything from trade policy to agriculture policy to health care policy. Outside the office, Nicole can be found trying new restaurants (usually Italian), taking an occasional barre class and cheering on the Cincinnati Bengals.
Nicole Longo
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Case study: How seniors could face access disruptions because of the IRA’s price setting provisions
Access
Government Price Setting
Medicare
Case study: How seniors could face access disruptions because of the IRA’s price setting provisions
Case study: How seniors could face access disruptions because of the IRA’s price setting provisions