Evidence Suggests IRA is a ‘Poorly Designed Policy’ | AMCP Annual 2025

While the intent of the Inflation Reduction Act (IRA) was to lower prescription drug costs, its unintended consequences may be leading to higher patient expenses at the pharmacy counter, according to Julie Patterson, Pharm.D., Ph.D., senior director of research at the National Pharmaceutical Council (NPC).

Speaking at the AMCP 2025 annual meeting in Houston earlier this week in a session titled, "Inflation Reduction Act Ripple Effects: Considerations for Patient Access and 340B," Patterson discussed how the IRA’s drug price negotiation program may fall shorter than expected in the financial relief for Medicare beneficiaries.

As a researcher at a 70-year-old health policy research organization, she noted that she prioritizes looking at the evidence.

Evidence suggests the IRA is a “poorly designed policy with unintended consequences on clinical research, uncertain impact on patients and it’s costing more than originally anticipated.”

Patterson highlighted NPC research showing that the policy could lead to delayed drug launches, fewer additional indications for existing drugs and a “chilling effect” on post-approval clinical research.

However, she noted that it remains unclear how these changes will impact patients directly.

It was also discussed how Medicare beneficiaries will experience cost changes at the pharmacy counter.

She shared that the Kaiser Family Foundation estimates approximately 1.5 million Medicare beneficiaries could benefit from the IRA’s $2,000 annual out-of-pocket cap.

In addition, some could find relief in the ability to spread their out-of-pocket expenses throughout the year.

Although, she pointed out that neither of these provisions is part of the IRA’s drug price negotiation program itself.

Instead, Patterson shared that some studies indicate that negotiated drug prices may actually result in higher costs for patients.

“What we don't know yet is what the impact will be on patients at the pharmacy counter because what patients pay for their drugs is a reflection of their pharmacy benefit design,” she shared.

With formulary changes expected in 2026, Patterson noted she and her team at NPC will continue monitoring shifts in patient access, cost-sharing and utilization management to better understand the full impact of the IRA’s policies on Medicare beneficiaries and the unintended consequences at hand.