Alliance Applauds Patient Affordability Provisions in Inflation Reduction Act

WASHINGTON, DC (Sept. 19, 2022) — The Alliance for Aging Research commends Congress for including in the Inflation Reduction Act of 2022 several provisions that will improve prescription drug affordability and access for Medicare Part D beneficiaries.

Specifically, the Alliance is pleased that the Act:

• Expands the low-income subsidy program; eliminates beneficiary out-of-pocket costs for Part D covered vaccines;
  
• Limits beneficiaries’ annual out-of-pocket Part D spending starting at $2,000; requires drug companies to pay rebates if prices rise faster than the rate of inflation;
  
• Limits insulin copayments to $35 a month;
  
• And allows Part D beneficiaries to pay their out-of-pocket costs in monthly installments, rather than all at once, should they so choose.

“These changes will help ensure that more Medicare beneficiaries have access to the prescription drugs they need to manage chronic, life-threatening, and disabling conditions,” said Michael Ward, Vice President of Public Policy and Government Relations at the Alliance. “The Alliance has long-advocated for these Medicare Part D improvements and we stand ready to work with the Centers for Medicare and Medicaid Services (CMS) and Congress to ensure that implementation of each of these provisions occurs in a timely and efficient fashion while safeguarding the health and well-being of older individuals and underserved communities.”

Despite the much-needed Medicare modifications contained in the Inflation Reduction Act of 2022, the Alliance remains concerned that other enacted provisions pose a threat to patient access to current and future breakthrough treatments.

“In particular, we are concerned that CMS will utilize cost-effectiveness methodologies – principally the quality-adjusted life year (QALY) – that discriminate against older adults and people with disabilities,” says Ward.

Since 2019, the Alliance has supported the National Council on Disability (NCD), an independent federal agency, in its recommendation cautioning against permitting the use of discriminatory price-setting methodologies, such the QALY. The NCD opposes these methodologies because they would undermine the Affordable Care Act (ACA) and major U.S. disability and civil rights laws. In February of this year, the NCD’s 2022 Health Equity Framework for People with Disabilities specifically proposed a “blanket [legislative] prohibition” on the use of QALYs by “any federal agency” and last November recommended language to unambiguously bar QALYs in the reconciliation bill.

As such, we continue to urge federal policymakers in Congress and within the Department of Health and Human Services (HHS) to reject the use of the QALY in federal policies and programs, including in the new system by which CMS will be implementing negotiated prices for certain drugs.

“It is essential that HHS and CMS undertake a transparent, intentional, and inclusive process to implement the various prescription drug provisions in the Inflation Reduction Act of 2022 and work with stakeholders like the Alliance to ensure that Medicare beneficiaries have equitable access to prescription drugs,” says Ward.

The Alliance welcomes the opportunity to partner with HHS and CMS to ensure that implementation of the changes contained in the Inflation Reduction Act of 2022 achieves what Congress intended: to overcome the financial barriers to needed therapies for those served by the Medicare program.

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The Alliance for Aging Research is the leading nonprofit organization dedicated to accelerating the pace of scientific discoveries and their application to vastly improve the universal human experience of aging and health. The Alliance believes advances in research help people live longer, happier, more productive lives and reduce healthcare costs over the long term. For more than 30 years, the Alliance has guided efforts to substantially increase funding and focus for aging at the National Institutes of Health and Food and Drug Administration; built influential coalitions to guide groundbreaking regulatory improvements for age-related diseases; and created award-winning, high-impact educational materials to improve the health and well-being of older adults and their family caregivers. For more information, visit www.agingresearch.org.

For more information about the Alliance for Aging Research or to interview an expert on this topic, please contact Katie Riley, Vice President of Communications, at [email protected]