Harvard Study Finds IRA Drug Reforms Helping Medicare Patients Stay on Medications

A Harvard-backed study published in JAMA Internal Medicine finds that the Inflation Reduction Act's drug provisions, which took effect January 1, 2024, helped Medicare beneficiaries stay on their medications by eliminating catastrophic coverage coinsurance and effectively capping annual out-of-pocket costs at approximately $3,300. Medicare Part D beneficiaries ages 62-67 experienced a 4.9 percentage point reduction in cost-related medication nonadherence, with those managing two or more chronic conditions seeing a 7.8 percentage point improvement. However, researchers Rishi Wadhera and Lucas Marinacci found no corresponding decrease in overall healthcare costs or financial anxiety among Medicare beneficiaries, while privately insured adults saw medication nonadherence rise more than 2 percentage points during the same period. The findings suggest the reforms address medication affordability but leave broader financial burdens unresolved and create disparities between Medicare and privately insured populations.

Impact of IRA Drug Reforms on Medicare Medication Adherence

• ▪Medicare beneficiaries were less likely to report skipping, rationing, or foregoing medications due to cost after the Inflation Reduction Act's provisions took effect on January 1, 2024.
• ▪Cost-related medication nonadherence rose more than 2 percentage points for privately insured adults during the same period the Inflation Reduction Act provisions were in effect.
• ▪Researchers used data from the National Health Interview Survey, an annual survey of about 27,000 U.S. adults conducted by the Centers for Disease Control and Prevention.
• ▪The Inflation Reduction Act's 2024 provisions effectively capped annual out-of-pocket costs at approximately $3,300 per year for Medicare beneficiaries with high medication spending.
• ▪Medicare Part D beneficiaries between ages 62 and 67 experienced a 4.9 percentage point reduction in cost-related medication nonadherence during the first year of the Inflation Reduction Act's eligibility.
• ▪The Inflation Reduction Act eliminated the 5 percent coinsurance requirement for catastrophic coverage for Medicare beneficiaries with high medication spending in 2024.
• ▪More than 1 in 4 U.S. adults struggle to afford their prescription medications.
• ▪The study on the Inflation Reduction Act's impact on medication adherence was published in JAMA Internal Medicine.
• ▪The Inflation Reduction Act's prescription drug cost-cutting provisions took effect on January 1, 2024.

Greatest Benefits for Patients with Multiple Chronic Conditions

• ▪Rishi Wadhera is an HMS associate professor of medicine at Beth Israel Deaconess Medical Center.
• ▪Lucas Marinacci is a cardiologist and HMS instructor in medicine at Beth Israel Deaconess Medical Center.
• ▪Rishi Wadhera is associate director and section head of health policy research at the Richard A. and Susan F. Smith Center for Outcomes Research.
• ▪Medicare beneficiaries managing two or more chronic conditions saw a 7.8 percentage point reduction in cost-related medication nonadherence after the Inflation Reduction Act provisions took effect.

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