In August 2024, the IRA’s drug pricing provisions reached a significant milestone, with the Centers for Medicare and Medicaid Services (CMS) announcing the final negotiated prices for the first ten drugs subject to negotiation. [...] The IRA’s Drug Pricing Provision: What’s at Stake on the Ballot? The IRA’s drug pricing provision is still in its nascent stage, and a political change in the White House or in Congress could derail implementation. [...] While this would not mean that the challengers to the law automatically win (in the case of the ACA lawsuit, for instance, state attorneys general stepped in to defend the law), it does make defending the law more difficult. [...] In August 2024, the IRA’s drug pricing provisions reached a significant milestone, with the Centers for Medicare and Medicaid Services (CMS) announcing the final negotiated prices for the first ten drugs subject to negotiation. [...] The IRA’s Drug Pricing Provision: What’s at Stake on the Ballot? The IRA’s drug pricing provision is still in its nascent stage, and a political change in the White House or in Congress could derail implementation.
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Table of Contents
- September 4, 2024 1
- Where Does IRA Implementation Stand Heading into the Election? 1
- The IRA is a sweeping piece of federal legislation signed into law by President Biden in August 2022. The law includes significant investment in climate and energy policies as well as major health care provisions, most notably changes to Medicare. One... 1
- In August 2024, the IRA’s drug pricing provisions reached a significant milestone, with the Centers for Medicare and Medicaid Services (CMS) announcing the final negotiated prices for the first ten drugs subject to negotiation. These prices were annou... 2
- Percent difference from list to negotiated price 2
- Negotiated maximum fair price (30-day supply) 2
- List price (30-day supply) 2
- CMS selected drugs for negotiation (first round) 2
- 79% 2
- $113 2
- $527 2
- Januvia (diabetes) 2
- 76% 2
- $119 2
- $495 2
- Fiasp (diabetes) 2
- 68% 2
- $178.50 2
- $556 2
- Farxiga (diabetes, heart failure, chronic kidney disease) 2
- 67% 2
- $2,355 2
- $7,106 2
- Enbrel (rheumatoid arthritis, psoriasis, psoriatic arthritis) 2
- 66% 2
- $197 2
- $573 2
- Jardiance (diabetes, heart failure, chronic kidney disease) 2
- 66% 2
- $4,695 2
- $13,836 2
- Stelara (psoriasis, psoriatic arthritis, crohn’s disease, ulcerative colitis) 2
- 62% 2
- $197 2
- $517 2
- Xarelto (blood clots, coronary or peripheral artery disease) 2
- 56% 2
- $231 2
- $521 2
- Eliquis (blood clots) 2
- 53% 2
- $295 2
- $628 2
- Entresto (heart failure) 2
- 38% 3
- $9,319 3
- $14,394 3
- Imbruvica (blood cancers) 3
- Source: CMS.gov, Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 (August 14, 2024) 3
- CMS will announce the next slate of 15 drugs subject to negotiation by February 1, 2025, which will kick off another multi-month negotiation process similar to what we saw for the first ten drugs. CMS will announce maximum fair prices for this second ... 3
- The IRA’s Drug Pricing Provision: What’s at Stake on the Ballot? 3
- The IRA’s drug pricing provision is still in its nascent stage, and a political change in the White House or in Congress could derail implementation. 3
- Congress 3
- Repealing or changing an existing law takes an act of Congress. Right now, Republicans have a razor thin majority in the House, while Democrats maintain a razor thin majority in the Senate. But the November election could change this, enabling legisla... 3
- White House 3
- Even if control of Congress remains unchanged, a party change in the White House could still impact IRA implementation. Despite each presidential candidate taking relatively similar public stances on the high price of prescription drugs, a Trump Admin... 3
- A new administration could also influence how vigorously (if at all) the IRA drug pricing provisions are defended in the multiple lawsuits drug manufacturers have brought challenging the law since it went into effect. If these lawsuits are not resolve... 3
- As always, elections matter. The IRA’s Medicare reforms are among many health policies that could change drastically depending on the outcome of the presidential and other races. Watch this space in the coming weeks as Health Care on the Ballot explor... 4