June 21, 2024

Market Access and the Inflation Reduction Act

market access IR POV screenshots

The Inflation Reduction Act of 2022 (IRA) institutes Medicare changes that include the ability to negotiate drug prices, limit price increases and cap out-of-pocket costs for beneficiaries. Understanding the far-reaching implications of these provisions is crucial for market access professionals to successfully navigate the new dynamics and plan for success in the future.

In this POV, we outline the provisions and their implications, point out key questions to which market access professionals should have ready answers and offer a spectrum of assistance in finding those answers. Some of the topics included are:

  1. Negotiating Drug Price
    • Implications: Price negotiations will impact reimbursement rates, market access, and overall revenue. We must anticipate potential price adjustments and adapt our pricing strategies accordingly.
  2. Limiting Price Increases
    • Implications: Our forecasting models need recalibration. How will these limits affect revenue projections? What adjustments should we make to launch pricing and long-term strategies?
  3. Out-of-Pocket Cost Caps
    • Implications: While this benefits patients, it affects payer dynamics. How will payers respond? What impact will this have on formulary placement and patient access?
  4. Key Questions for Market Access Professionals
  5. Assistance Spectrum

In this dynamic landscape, our role as market access professionals is more critical than ever. By proactively addressing these questions and seeking innovative solutions, we can navigate the IRA’s impact and drive successful commercialization. Access the full POV for more details.

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