The Inflation Reduction Act and Out-of-Pocket Medicare Drug Costs

By 2025, the IRA should lower out-of-pocket Medicare drug costs by 8% to 87% for patients with cardiac conditions that often require higher-priced medications.

The Inflation Reduction Act (IRA) of 2022 includes several initiatives aimed at reducing out-of-pocket drug costs for Medicare recipients, such as gradually abolishing coinsurance for so-called “catastrophic” coverage (phase of coverage beginning after out-of-pocket threshold is met [$7050 in 2022]) and capping annual out-of-pocket drug costs at $2000 by 2025. In this analysis, investigators projected the effects of those changes on average out-of-pocket costs for four cardiovascular conditions frequently necessitating high-cost guideline-recommended medications: severe hypercholesterolemia, heart failure with reduced ejection fraction (HFrEF), HFrEF with atrial fibrillation (HFrEF-AF), and cardiac transthyretin amyloidosis (TTR-amyloid).

Re…

Reviewing Author

Kirsten E. Fleischmann, MD, MPH, FACC

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association

Kirsten E. Fleischmann, MD, MPH, FACC

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association

The Inflation Reduction Act and Out-of-Pocket Medicare Drug Costs

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Reviewing Author