Medicare Drug Price Negotiation: Saving money for Medicare, but what about patients? – 2

Lexology March 28, 2025
DLA Piper

Introduction

The Inflation Reduction Act (IRA) is anticipated to result in changes to Medicare beneficiaries’ ability to affordably access their medications in the Medicare drug benefit. This can include changes in cost sharing, such as increased co-pays and coinsurance, or requiring additional steps for providers and beneficiaries to receive prescribed medications, such as prior authorization requirements. Our evaluation of 2025 Medicare Part D formularies for the 25 drugs selected for Drug Price Negotiation in Medicare Part D shows several selected drugs have higher co-pays in 2025 relative to 2024. Moreover, selected specialty drugs nearly always have a prior authorization requirement. This provides both a baseline assessment and an indication of initial trends.

While roughly twenty percent of beneficiaries are expected...

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