Inflation Reduction Act 2022 for Pharma and Healthcare

Inflation Reduction Act 2022

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Last month, the Biden-Harris Administration took a new stance on healthcare costs rising exponentially across the US by signing the Inflation Reduction Act (IRA). IRA passage with provisions aiming to reduce out-of-pocket costs is truly the capstone achievement.

ID: Tr01 CATEGORY: Healthcare Services GEOGRAPHY: Global

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Inflation Reduction Act (IRA): Policy Overview and Benefits

President Joe Biden signed the Inflation Reduction Act (IRA) into law which aims to combat drug price increases and reduce overall healthcare costs for millions of Americans.

IRA Provisions & Key Takeaways

IRA enables Medicare to negotiate prices of prescription medicines with pharma companies, starting with 10 drugs covered in Medicare Part D in 2026. More drugs will be up for negotiation each year for a total of 60 drugs by 2029
Beginning in 2023, out-of-pocket insulin costs will be capped at $35 per month for Medicare beneficiaries. IRA also institutes a $2000 annual cap for beneficiaries’ part D spending, starting in 2025
From October, if the price of a Part D prescription drug is raised by more than the rate of general inflation, the drug manufacturer will have to give Medicare the amount of the increase above the inflation as rebates
Starting in 2026, bestseller Medicare drugs that have been on market for over a decade without generic or biosimilar competition will face a minimum discount of 25-60% that is subject to negotiation with HHS
The bill extends Affordable Care Act (ACA) subsidies that reduce monthly premiums to the beneficiaries for the next 3 years which was introduced back in 2021
Earlier, Medicare enrollees who choose branded drugs over generics had to spend $3,000 out-of-pocket to qualify for the catastrophic threshold and bear 5% coinsurance thereafter on prescribed drugs. IRA has eliminated that from 2024

Inflation Reduction Act (IRA): Implications on Various Stakeholders

The inflation Reduction Act (IRA) proposes a set of provisions with an overarching goal to reduce patients’ out-of-pocket costs; these newly-introduced prospects impact a set of stakeholders in different ways, from drug development to price point.

Negative Impact on Revenue

A combination of the new Medicare inflation rebates with existing price protections might result in certain price increases actually reducing the manufacturer’s net revenue after rebates for a given product.

Hike in Launch Prices

Drug manufacturers may retain one way to escape future inflation rebate liabilities and reduce the need for later price increases by setting up higher launch prices of new products, resulting in higher benchmark period prices.

Reduction in out-of-pocket costs

Certain provisions including an annual spending cap of $2,000, eliminated coinsurance under catastrophic coverage, and limited insulin cost at $35 per month, will reduce patients’ out-of-pocket costs for healthcare.

A shift in the investment landscape

The exclusion of small biotech companies from price negotiations would discourage the development of new drugs or reduce new venture capital investments in start-up pharmaceutical companies.

Cost Diversion Loophole

IRA has generated concerns that Medicare drug price negotiations could leave a loophole, allowing manufacturers to shift costs to consumers with private health insurance and employers as its impact is less clear in these areas.

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Methodology for Database Creation

Our database offers a comprehensive list of healthcare centers, meticulously curated to provide detailed information on a wide range of specialties and services. It includes top-tier hospitals, clinics, and diagnostic facilities across 30 countries and 24 specialties, ensuring users can find the healthcare services they need.

Additionally, we provide a comprehensive list of Key Opinion Leaders (KOLs) based on your requirements. Our curated list captures various crucial aspects of the KOLs, offering more than just general information. Whether you're looking to boost brand awareness, drive engagement, or launch a new product, our extensive list of KOLs ensures you have the right experts by your side. Covering 30 countries and 36 specialties, our database guarantees access to the best KOLs in the healthcare industry, supporting strategic decisions and enhancing your initiatives.

How Do We Get It?

Our database is created and maintained through a combination of secondary and primary research methodologies.

1. Secondary Research

With many years of experience in the healthcare field, we have our own rich proprietary data from various past projects. This historical data serves as the foundation for our database. Our continuous process of gathering data involves:

Analyzing historical proprietary data collected from multiple projects.
Regularly updating our existing data sets with new findings and trends.
Ensuring data consistency and accuracy through rigorous validation processes.

With extensive experience in the field, we have developed a proprietary GenAI-based technology that is uniquely tailored to our organization. This advanced technology enables us to scan a wide array of relevant information sources across the internet. Our data-gathering process includes:

Searching through academic conferences, published research, citations, and social media platforms
Collecting and compiling diverse data to build a comprehensive and detailed database
Continuously updating our database with new information to ensure its relevance and accuracy

2. Primary Research

To complement and validate our secondary data, we engage in primary research through local tie-ups and partnerships. This process involves:

Collaborating with local healthcare providers, hospitals, and clinics to gather real-time data.
Conducting surveys, interviews, and field studies to collect fresh data directly from the source.
Continuously refreshing our database to ensure that the information remains current and reliable.
Validating secondary data through cross-referencing with primary data to ensure accuracy and relevance.

Combining Secondary and Primary Research

By integrating both secondary and primary research methodologies, we ensure that our database is comprehensive, accurate, and up-to-date. The combined process involves:

Merging historical data from secondary research with real-time data from primary research.
Conducting thorough data validation and cleansing to remove inconsistencies and errors.
Organizing data into a structured format that is easily accessible and usable for various applications.
Continuously monitoring and updating the database to reflect the latest developments and trends in the healthcare field.

Through this meticulous process, we create a final database tailored to each region and domain within the healthcare industry. This approach ensures that our clients receive reliable and relevant data, empowering them to make informed decisions and drive innovation in their respective fields.