2024 Trends, Events, and Developments (TEDs) in the Payer World—Consequences of the IRA: An Update

Welcome to the 2024 TEDs issue on the Inflation Reduction Act! I am Cynthia Miller, MD, MPH, FACP; Vice President, Medical Director—Access Experience Team; and editor of All Access Newsletter. This edition focuses on the impacts the IRA will have on various segments of the payer world. Our expert ex-payers will provide insights into these trends and developments and discuss how they foresee them impacting the health care system, especially patients, health systems, and the pharmaceutical industry.

Two Unintended Consequences of the IRA We Aren’t Talking Enough About
Andrew Cournoyer, Senior Vice President, Director, Access Experience Team—PRECISIONvalue
Andrew discusses two unintended consequences of the resulting from the Inflation Reduction Act (IRA).   In this article, Andrew highlights the IRA’s small manufacturer exemption that aims to provide financial protections, yet could actually imposes access obstacles. Additionally, he details how the Medicare Part D redesign has negatively impacted plan offerings and its resulting effect on beneficiary choice.

The IRA: Evolving Toward Pharmacoequity
Maureen Hennessey, Senior Vice President, Director of Value Transformation—PRECISIONvalue
Maureen introduces the concept of pharmacoequity and the IRA’s potential positive and negative impacts on it. She provides solutions for payers and pharmaceutical companies to improve health equity and promote pharmacoequity.

Copay Smoothing for Medicare Enrollees: Potential Impacts for Plans and Pharmaceutical Manufacturers
Dan Danielson, Senior Director, Access Experience Team—PRECISIONvalue
Dan discusses the copay smoothing provision of the IRA and the potential impact on Medicare drug plans. In addition, he proposes several ways that pharmaceutical companies can educate consumers and providers on copay smoothing to improve drug uptake and adherence.

Drug Pricing Reforms: Perspectives on Federal and State Efforts
Ryan Cox, Vice President, Director, Access Experience Team—PRECISIONvalue
Ryan dives into the drug pricing reforms at both the federal and the state level. He reviews the potential unintended consequences of the IRA on innovation. He also delves into legislation at the state level that is being developed to manage drug spend, including Prescription Drug Affordability Boards and drug importation.

We believe you will find this issue on unintended consequences of the IRA and the impact on market access insightful as you navigate the payer landscape. As always, please feel free to drop me a note and let me know if you have a topic suggestion for the payer team to address, and we’ll do our best to cover it in a future edition.

Best Regards,

Cynthia Miller
MD, MPH, FACP
VP, Medical Director
Access Experience Team
EMAIL CYNTHIA