Unintended consequences of government price setting in Medicare Part D

The USA’s Biden administration last Thursday released the government-set prices for the first 10 medicines selected under the Inflation Reduction Act (IRA).

The announcement left out important context about what is already happening in Medicare Part D because of the changes in the IRA and how Medicare patients are negatively impacted, noted Nicole Longo, deputy vice president of public affairs at Pharmaceutical Research and Manufacturers of America (PhRMA), in the trade group’s press release.

PhRMA president and chief executive Steve Ubl stated: “The administration is using the IRA’s price-setting scheme to drive political headlines, but patients will be disappointed when they find out what it means for them. There are no assurances patients will see lower out-of-pocket costs because the law did nothing to rein in abuses by insurance companies and PBMs who ultimately decide what medicines are covered and what patients pay at the pharmacy. The ironically named Inflation Reduction Act is a bad deal being forced on American patients: higher costs, more frustrating insurance denials and fewer treatments and cures for our loved ones.” His full statement can be read here.