Seniors are feeling the true cost of drug price “negotiations.”
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. Additionally, most Part D patients are not expected to experience any cost savings from price setting in 2026. Instead, millions are likely to face increased costs.
Higher costs and less access are not what seniors were promised when the IRA was signed into law.
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The IRA's Unintended Consequences
Higher costs for medicines in Medicare.
What Medicare patients pay depends on many factors, including benefit design. Insurers and PBMs have substantial control over what that benefit design looks like, what hoops people have to jump through, and what patients pay at the pharmacy. The IRA did nothing to rein in their control, and millions of seniors are likely to pay more for their medicines as a result.
More frustrating insurance denials and barriers to medicines.
The IRA’s price setting measures, coupled with structural changes to Medicare Part D, have put much of what has worked for patients in the program at risk. Seniors are facing more access barriers, including higher premiums and fewer plan options, because of the IRA. And insurers have made clear they plan to restrict coverage in Part D because of the IRA.
Long-term negative impact on drug development.
The IRA’s price setting provisions actively discourage critical R&D, threatening future access to new treatments and cures. Several economic experts predict significant impacts in 10 to 20 years, with hundreds of medicines at risk of not being developed. The impacts will be felt for decades to come, and patients are the ones that will lose out.