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Examining the IRA’s Impacts and the Differences of a Second Biden vs Trump Term at AXS24

Author(s):

During their session at Asembia’s AXS24, Sarah Butler and Lindsay Greenleaf of ADVI Health will examine the current status of the Inflation Reduction Act (IRA) and future considerations in health care in the context of the upcoming presidential election.

Sarah Butler, chief commercial officer, and Lindsay Greenleaf, vice president and solution leader, federal and state policy, both from ADVI Health, previewed their session “2024 Election Policy Issues and the Patient Journey Ripple Effect: IRA, the War on Cancer, and More” at Asembia’s AXS24 Summit, being held April 28 to May 2, 2024, in Las Vegas, Nevada.

They will be joined during their session by C. Lyn Fitzgerald, vice president of sales, Ontada, and Hillary Cavanaugh, senior director, PhRMA, and the former director of the Division of Ambulatory Payment Models, Center for Medicare and Medicaid Innovation.

Transcript

Can you provide a preview of what you plan to discuss during your session at the upcoming Asembia meeting?

Butler: Our panel is really going to focus on giving an overview of what the current status is of the Inflation Reduction Act, and what implementation is like today, what does the future look like, and what are some of the current market reactions that we're seeing. We'll specifically focus on manufacturers—so, we’ll focus on the industry perspective and our experience working closely with many of our customers. And then we'll talk about the provider perspective, the payer perspective, and also what the impacts are for patients.

Then in the context of the election, we'll focus on what is the future of the Inflation Reduction Act in the context of a Biden vs Trump administration, and what are some of the things that manufacturers, payers, and providers should be considering going into election season.

Greenleaf: In the context of the election, we know that President Biden has proposed to significantly ban the law and expand the impact of the government price setting policy, specifically. We'll spend some time on the panel talking about things that President Biden could do under his administrative authority or things that might take an act of Congress to actually get enacted. And then contrast that with what would be a potential President Trump administration 2.0. We expect that it would likely be a little bit less punitive implementation of the law, and possibly some more transparency.

Then also Trump [would take] a bit of a different angle outside of the Inflation Reduction Act, looking again at foreign free-loading, [which is] the idea of international reference pricing for prescription drugs. We'll talk about what some of those proposals might look like.

What else are you looking forward to at Asembia?

Butler: For me, I love Asembia because it's a great opportunity to connect with clients, former colleagues, and friends across the industry. So, for me, that's always the highlight every single year. And then I've seen on the agenda there's some sessions focused on innovative payment models for cell and gene therapy that look really interesting and are very relevant to some of the work that we do here at ADVI, and also sessions that are focused on PBM [pharmacy benefit manager] transparency that look very interesting.

Greenleaf: I'm looking forward to sessions on Medicare Part D and what the Part D plans might be doing next year as they react to changes to the Part D benefit redesign. We've had data come out showing us plan reactions to changes already for the 2024 benefit year: You have the standalone PDP [prescription drug plan] with premium increases of 21% for this year, which was a bit unexpected. We have seen other projections for next year, 2025, when really significant changes take place—the $2000 out-of-pocket cap officially kicks in—some projections of the premiums being increased even more dramatically. So, I think sessions that talk about payer reactions from the Part D space will be of interest.

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