IRA recently passed. Basically it will allow government to negotiate drug prices with pharma companies. Specifically, it'll be 20 chemo drugs by 2029 that gov will negotiate pricing on. They mentioned mostly oral chemo such as palbociclib and ibrutinib/etc. One article I read on ASCO projects almost 50% decline in drug prices. Can we discuss how this IRA will affect private practice onc or community hospital onc reimbursement?
Inflation reduction act and oncology reimbursement
- Thread starter osprey099
- Start date
- Joined
- Mar 6, 2005
- Messages
- 21,376
- Reaction score
- 17,904
Since this is all about Medicare Part D and not Part A, which is what infusions are billed on, I don't think it will have a significant impact unless your clinic/hospital also runs an outpatient specialty pharmacy (which many do).
But the thing to keep in mind is that they're not mandating the price that pharmacies charge for them, just what the manufacturer charges for them. So for a pill that costs $100 each from the manufacturer and the pharmacy sells for $110, when the price gets knocked down to $50 from the manufacturer, the pharmacy will sell it for $60 and still get their $10 profit, but the overall cost savings is still $50.
- Joined
- Aug 15, 2009
- Messages
- 615
- Reaction score
- 270
Exactly what gutonc says. I spend at least 30 minutes each day explaining oral oncology drug pricing dynamics to patients and families. This will help me cut that down by at least 5 minutes a day. 
- Joined
- Mar 6, 2005
- Messages
- 21,376
- Reaction score
- 17,904
1. I don't even bother anymore. I shrug my shoulders, tell them the whole system is f'd and that we'll do our best to get them the meds I'm ordering at a price they can afford.Exactly what gutonc says. I spend at least 30 minutes each day explaining oral oncology drug pricing dynamics to patients and families. This will help me cut that down by at least 5 minutes a day.
2. It will probably make it worse actually.
