I recently spoke at America’s Physician Groups’ annual fall conference to dive deeper into the Inflation Reduction Act’s (IRA) limitations. Joined by Adam Finkelstein, Counsel for Manatt, Phelps & Phillips, LLP and Clare Pierce-Wrobel, Director of Delivery System Reform for The White House, I touched on how provisions in the IRA put the government between patients and their doctors.
Here are three things we touched on:
- Government price-setting poses a threat to R&D, limiting patients’ treatment options. Allowing the government to arbitrarily set the prices of medicines ignores the nature of the R&D process and gives policymakers the power to determine winners and losers when it comes to medicines that provide lifesaving care.
- The IRA misses the mark on addressing the real problems patients face at the pharmacy counter. The law fails to address abusive practices by PBMs and insurers that drive up costs for patients and the health care system, such as marking up medicines and withholding rebates and discounts.
- Government price setting undermines the Medicare Part D program and will likely reduces access to lifesaving treatments. On a positive note, there were changes made to Part D that will lower some patient costs, like a cap on what seniors will need to pay out of pocket for their medicines. The IRA doesn’t prohibit insurers from using aggressive utilization management to steer access or moving treatments to more expensive formulary tiers that actually increase out-of-pocket costs.
We need policies that reduce health care costs, protect medicine accessibility and promote drug development to ensure we have the right tools to treat patients when they’re sick. Learn more here.
Mike Ybarra
Michael Ybarra, M.D., is an emergency physician and Chief Medical Officer at PhRMA. He also serves as Senior Vice President in Advocacy and Strategic Alliances. In these roles, he leads PhRMA’s stakeholder engagement and strategic partnerships on federal and international health policy issues. He is PhRMA’s liaison representative to the Advisory Committee on Immunization Practices and is the co-convener of PhRMA’s R&D Leadership Forum. Dr. Ybarra continues to see patients clinically in the emergency department at MedStar Georgetown University Hospital.
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Mike Ybarra
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ICYMI: 3 takeaways on the IRA’s unintended consequences from America’s Physician Groups’ 2023 annual fall conference
Access
Government Price Setting
Medicare
Part D
PBMs/Insurance
Research and Development
ICYMI: 3 takeaways on the IRA’s unintended consequences from America’s Physician Groups’ 2023 annual fall conference
ICYMI: 3 takeaways on the IRA’s unintended consequences from America’s Physician Groups’ 2023 annual fall conference