The IRA Fixed One Medicare Part D Distortion—But Patients Now Face New Tradeoffs (rerun)
This week, we're rerunning some popular posts while we put the finishing touches on DCI’s 2026-27 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors . Click here to see the original post from June 2026. By Bryce Platt, PharmD For years, Medicare Part D plans often preferred high-list/high-rebate branded multiple sclerosis (MS) drugs over lower-cost generics. That was rational behavior inside an irrational system. The Inflation Reduction Act (IRA) offers one example of how incentives can change behavior in the system. New research in JAMA Health Forum reveals a significant reversal in Medicare Part D formulary coverage for MS drugs. After years of plans favoring brand-name drugs over generics, 2025 formularies shifted to near-universal generic coverage. However, in return patients got narrower formularies, higher upfront costs, and way more taxpayer dollars spent than expected. While this wasn’t the case for all drug classes, in MS, the IRA Part D redesign has forced plans to care more about net drug spending. Below, we analyze the formulary data and explain why the coverage patterns changed so abruptly—and what new tradeoffs have emerged. Read more » © 2006-2026 HMP Omnimedia, LLC d/b/a Drug Channels Institute , an HMP Global Company. All rights reserved. This Feed is for personal non-commercial use only.

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