top of page
  • Writer's pictureAventria Health Group

The IRA Provisions: It’s NOT Business as Usual

Pharmaceutical SVP/VP Market Access, SVP Therapeutic Business Units, Brand Directors, SVP/VP Policy/Government Affairs, US-Executive Committee Members:

Recently, Peter J. Neumann, ScD, director of the Center for the Evaluation of Value and Risk in Health (CEVR) at Tufts Medical Center, was featured on a Relentless Health Value™ podcast. The discussion focused on CMS drug negotiation provisions in the Inflation Reduction Act (IRA). It also included implications for designing strategies that position your organization to land on the “right price” of drugs.

Hear what Dr. Neumann had to say here.

The big challenge for all stakeholders (CMS, Pharma, payers/PBMs, providers) is interpreting the legislation and how CMS will operationalize negotiations to determine the right drug price. The crucial question that needs to be asked is whether the intent of the legislation is drug cost containment or achieving a value-based, right price.

Since these are two disparate outcomes, stakeholders will need clear evidence-based negotiation strategies with contingency plans to find the right balance for clinical benefit, unmet need, and value delivered to the treatment population.

The IRA Is More Than CMS Drug Negotiation

In addition to CMS drug negotiation provisions, the IRA will create unprecedented changes for Pharma and the healthcare system. No one can accurately predict exactly how these will play out. Most organizations have modeled the potential impact on revenue but not:

  • Downstream consequences on customer business models

  • Drug access/coverage requirements

  • Pipeline/development platforms

  • Launch list price strategies

  • Overall patient

These considerations may have a greater impact than drug pricing, and to that end, we strongly suggest these be answered as part of a total plan.

Aventria Health Group can help Market Access Leadership Teams leverage their position within the organization to create a strong, integrated planning process for responding to the IRA changes and other key dynamics. Our expertise and insights can assist organizations in navigating the complexities of the evolving healthcare landscape and strategizing for success


To learn more about our Executive ThinkTank process and how we can help you anticipate the unprecedented impact of the IRA and prepare for future success, please reach out to:

Dave Dierk, Co-President, 30-year sales and marketing thought leader in pharmaceutical diagnostics, biomedical, long-term care, managed care, employer, and pharmacy communications, at dave.dierk@aventriahealth.com.


Paul G. Pochtar, RPh, extensive experience in leading the successful market access commercialization of both primary care and specialty pharmaceuticals throughout their life cycle, including several landmark oncology products and other specialty therapeutics, at ppochtar@pinnaclehc.com.



Making a difference in patient care by helping patients, providers, and payers collaborate on shared priorities

Comments


bottom of page