Health Affairs December 14, 2023
The passage of last year’s Inflation Reduction Act (IRA) made major structural changes to the way Medicare covers and pays for prescription drugs. The law includes changes that will greatly improve patient prescription drug affordability by eliminating seniors’ cost-sharing obligations on vaccines, reducing out-of-pocket costs for insulin, and capping annual out-of-pocket costs at $2,000. The Centers for Medicare and Medicaid Services (CMS) reported that in 2025, these IRA Part D drug-related provisions could lead to an estimated $7.4 billion reduction in out-of-pocket spending for 18.7 million enrollees per year, or an average savings of $400 per affected enrollee.
However, these improvements in patient affordability could be offset if other IRA provisions deter access to medicines best suited to meet an...
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