August 16, 2022, marked a pivotal moment as President Biden signed the bipartisan Inflation Reduction Act (IRA), which had a heavy focus on alleviating patient costs. We were particularly encouraged by the enhancements to Medicare Part D, capping out-of-pocket expenses, limiting insulin costs, and eliminating cost-sharing for vaccines. These changes promise immediate relief to countless patients and the Chronic Disease Coalition is grateful for the federal leadership on this issue.
One year later, we continue to push for patient-focused implementation of the law. It is vital for policymakers to weigh the potential long-term consequences on new treatment development, particularly for complex and rare diseases, and the patients' ability to access these treatments.
The Chronic Disease Coalition has for years advocated against policies that put a wedge in between a patient and provider – and we cannot let the IRA fall into that category.
A key element of the law is the Medicare Drug Price Negotiation Program, aimed at establishing negotiated rates, or the Maximum Fair Price (MFP), for medications. While the intention is to reduce drug costs, there could be unintended but serious downsides to drug coverage, formulary preferences, accessibility, and even research and development. This could inadvertently create obstacles to accessing other medications, as insurance companies steer (limit patients to?) patients towards products with negotiated pricing, potentially diminishing their access to new treatments. Insurance companies already implement cost-saving strategies like restrictive formularies, step therapy, and stringent prior authorizations, which can hurt patients by limiting their access to the treatments recommended by their doctors.
The core of the matter remains: treatment decisions must be made between the patient and the provider. The introduction of artificially lowered prices can cut patients off from the medication that is going to work best for them, which can increase suffering or even make their condition worse.
The key lies in the Administration's approach to implementation. Patient needs and access to treatments must be central considerations during this process. The long-term implications of the law must be scrutinized, and patient perspectives must influence the direction taken.
The CDC encourages continued collaboration between policymakers, healthcare experts, and patients. Together, we can create a balanced implementation plan that supports patient well-being, promotes access to appropriate treatments, and fosters innovation in treatments and cures for the next generation. The ultimate goal is to establish a healthcare system that not only addresses the immediate needs of patients but also ensures a sustainable future where medical breakthroughs continue to transform lives.