Informing Medicare Prescription Drug Price Negotiations

Assessing the impact of the Inflation Reduction Act

LSE Investigators: Olivier Wouters
Region(s): US
Keywords: Drug Pricing, Pharma Access, Health Insurance, Health Policy

Dr Wouters was awarded a grant from the Commonwealth Fund (as Co-Principal Investigator) to study US drug pricing reforms. The collaborators on the project are based at the University of California San Diego and University of Washington.

The project is evaluating the impact of the recently passed Inflation Reduction Act on drug prices and spending in the US. The Inflation Reduction Act enables the US federal government, for the very first time, to negotiate the prices of prescription drugs. Medicare, a federal health insurance program for adults aged 65 years and older, has picked the 10 first drugs subject to negotiation; the negotiated prices for these products will come into effect in 2026. As part of the negotiation process, Medicare will compare the net prices of therapeutic alternatives to these 10 drugs and consider their relative clinical benefits and risks (also known as comparative effectiveness). Yet it is unclear how the clinical evidence will be combined with the data on net prices to arrive at final prices.

The team is collecting and synthesizing data on net prices and comparative effectiveness for the 10 first drugs subject to negotiation (as well as their therapeutic alternatives). These data will be used to estimate a range of potential price offers for each product, in a process mirroring the approach that Medicare might follow.

The authors plan to disseminate their findings to the broader health policy, payer, and research communities through a webinar and publications. The first paper from the project was published in December 2023.

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