INFLATION REDUCTION ACT NEGOTIATIONS: QUALITATIVE INSIGHTS FROM 25 PART D DRUG PRICE NEGOTIATIONS
Author(s)
Aniket Das, Ph.D.1, Tirna Bhattacharya, M.Sc.1, Jishna Das, M.Pharm.1, Ankita ., M.Pharm.1, Sanchari Barman, B.Tech.2, Varun Ektare, MPH3, Ayushman Ghosh, Ph.D.1, Tushar Pyne, Ph.D.1;
1Indence Research Private Limited, North 24 Parganas, India, 2Indian Institute of Technology Dhanbad, Dhanbad, India, 3Indence Research Private Limited, Thane West, India
1Indence Research Private Limited, North 24 Parganas, India, 2Indian Institute of Technology Dhanbad, Dhanbad, India, 3Indence Research Private Limited, Thane West, India
OBJECTIVES: The U.S. Inflation Reduction Act 2022 (IRA) introduced significant changes in Medicare drug price negotiations which aimed to reduce healthcare costs. The aim of this study was to generate insights into the drug price negotiations under the IRA spanning both oncological and non-oncological drugs.
METHODS: This qualitative review involved 25 Part D drugs over two cycles (2026-2027) with negotiated prices for initial price applicability (IPA) using publicly available CMS Maximum Fair Price (MFP) factsheet. We retrieved initial list prices, negotiated MFPs, discount percentages, and Medicare enrollee numbers for each of the Part D drugs.
RESULTS: A total of 25 drugs were negotiated under the U.S. Inflation Reduction Act (IRA), with 10 drugs in cycle 1 and 15 drugs in cycle 2. In cycle 1, nine non-oncology drugs (primarily for Diabetes and CKD) and one oncology drug (CLL/SLL/MCL) were included. In cycle 2, 11 non-oncology drugs (mainly for Diabetes and COPD/Asthma) and four oncology drugs (CLL/SLL/MCL, breast, and prostate cancer) were included. Medicare enrollee numbers were considerably higher for non-oncology drugs (ranged from 23,000-3.9 million), while only 14,000-35,000 for oncology drugs. The higher prevalence of Medicare enrollees for non-oncological indications revealed a trend with IRA-negotiated discount rates, with these groups of drugs receiving larger discounts (85% had rates >50%). In contrast, oncology drugs with smaller enrollee population, tended to have more modest discounts (4 out of 5 drugs had rates ≤50%).
CONCLUSIONS: This study findings highlight that the higher Medicare enrollee numbers for non-oncology drugs correspond to larger IRA-negotiated discount rates, reflecting the broader patient base and long-term cost savings. In contrast, oncology drugs, with smaller enrollee populations, experienced comparatively modest discounts, potentially due to their critical treatment demands and more volatile pricing. The findings indicate that future negotiations may focus on drugs targeting larger patient populations to enhance affordability for Medicare beneficiaries.
METHODS: This qualitative review involved 25 Part D drugs over two cycles (2026-2027) with negotiated prices for initial price applicability (IPA) using publicly available CMS Maximum Fair Price (MFP) factsheet. We retrieved initial list prices, negotiated MFPs, discount percentages, and Medicare enrollee numbers for each of the Part D drugs.
RESULTS: A total of 25 drugs were negotiated under the U.S. Inflation Reduction Act (IRA), with 10 drugs in cycle 1 and 15 drugs in cycle 2. In cycle 1, nine non-oncology drugs (primarily for Diabetes and CKD) and one oncology drug (CLL/SLL/MCL) were included. In cycle 2, 11 non-oncology drugs (mainly for Diabetes and COPD/Asthma) and four oncology drugs (CLL/SLL/MCL, breast, and prostate cancer) were included. Medicare enrollee numbers were considerably higher for non-oncology drugs (ranged from 23,000-3.9 million), while only 14,000-35,000 for oncology drugs. The higher prevalence of Medicare enrollees for non-oncological indications revealed a trend with IRA-negotiated discount rates, with these groups of drugs receiving larger discounts (85% had rates >50%). In contrast, oncology drugs with smaller enrollee population, tended to have more modest discounts (4 out of 5 drugs had rates ≤50%).
CONCLUSIONS: This study findings highlight that the higher Medicare enrollee numbers for non-oncology drugs correspond to larger IRA-negotiated discount rates, reflecting the broader patient base and long-term cost savings. In contrast, oncology drugs, with smaller enrollee populations, experienced comparatively modest discounts, potentially due to their critical treatment demands and more volatile pricing. The findings indicate that future negotiations may focus on drugs targeting larger patient populations to enhance affordability for Medicare beneficiaries.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE220
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Oncology, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), SDC: Urinary/Kidney Disorders