Health Affairs December 15, 2022
The Inflation Reduction Act (IRA), signed by President Biden on August 16, 2022 is the most substantial drug payment and coverage legislation enacted since the Medicare Modernization Act of 2003. The IRA promises to have important consequences, both intended and unintended, across the health care system. Further, the new law gives the Centers for Medicare and Medicaid Services (CMS) considerable discretion to implement a multidimensional “maximum fair price” (“MFP”) for affected drugs at or below the regulated MFP ceiling, putting a substantial burden on CMS to implement a sustainable and predictable price determination framework.
Major features of this legislation have been summarized previously. In this two-part article, we highlight some important consequences that flow from the IRA’s Medicare coverage and...
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