In an article for Health Affairs, Manatt Health Senior Advisor Ian Spatz provided considerations for the Centers for Medicare & Medicaid Services (CMS) as the agency soon begins implementing the drug negotiation provisions of the Inflation Reduction Act (IRA) of 2022.
Spatz explained that, since the IRA’s enactment, CMS will begin negotiating the price of some older drugs, an authority that is fundamentally different than those the agency has exercised in the past. CMS has traditionally set reimbursement rates for certain items and services in Medicare, but has not partaken in the negotiation of these prices. “While other nations have decades of experience in drug price regulation, the IRA creates a new challenge for Medicare’s administrators,” Spatz wrote. “How it carries out this work will have important implications for stakeholders and is critical to determining whether this new authority can be sustained or, as some may hope, built upon to regulate additional drug prices.”