The Inflation Reduction Act (IRA), a sweeping climate, health care and tax bill was signed into law this summer.

While the IRA undeniably brings some great wins for patients, there are some significant complexities to consider regarding the health care financing and delivery system in the U.S. and the many ways in which this bill will impact patients. Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation, delivers his analysis on the wins and misses of a bill as it relates to patients in the U.S.

“What I wish the bill did… is one: address the issue of formulary exclusions, and number 2: to have the patients benefit from the negotiated prices at the pharmacy. This is unbelievably unfair for patients! And this happens both with Medicare and with commercial plans,” says Dr. Robert Popovian.

Among the highlights in this episode:

1:09: Listener comment

1:58: The IRA sets a $2,000 annual cap for beneficiaries' Part D spending

3:32: Starting next year, seniors will not pay out-of-pocket costs for any of the vaccines covered under their Medicare Part D program and reasons why that’s important for them

5:01: How the federal government missed an opportunity to address the issue of patients paying their co-insurance or deductible based on the retail price of the medicine rather than prices negotiated by PBMs on their behalf

5:45: Another issue that is not addressed in the bill is the growing number of formulary exclusions

6:49: Is there any clinical or economic justification for excluding certain medications from national PBM formularies or is it just about profitability?

8:25: An analysis on the bill’s negative impacts regarding drug innovation

9:12: Which classes of medicines and disease areas might be negatively impacted by the bill

10:02: Further discussion of the main issues that the IRA could have addressed and the impact on patients

12:20: The IRA also brings some great wins for patients

13:22: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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