Inflation Reduction Act Part D Benefit Reforms: Impacts on Pharmaceutical Manufacturers, Plans, and Patients

Part D Changes Likely to Impact Stakeholder Financial Incentives and Behavior

In August 2022, President Biden signed into law the Inflation Reduction Act of 2022 (IRA). In addition to the drug negotiation and inflation rebate provisions in the IRA, the law includes several important amendments to the standard Medicare Part D benefit. These changes include a cap on insulin costs; eliminating beneficiary cost-sharing in the catastrophic phase; capping beneficiary premiums and out-of-pocket spending; eliminating the coverage gap; and modifying cost liability for Medicare, Part D plans, and drug manufacturers.

In addition to summarizing these Part D benefit-related provisions of the IRA, this Center for Healthcare Regulatory Insight Brief describes how these changes could affect financial incentives and behaviors of Part D plan sponsors and pharmaceutical manufacturers.

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Larry Kocot

Larry Kocot

Principal and Leader of the Center for Healthcare Regulatory Insight, KPMG US

+1 202-533-3674
Tracey McCutcheon

Tracey McCutcheon

Specialist Director, Advisory, KPMG US

+1 202-533-5380
Ross White

Ross White

Director, Advisory, KPMG US

+1 202-533-3691

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