Changes in Medicare Part D Plan Designs After the Inflation Reduction Act

How did prescription drug coverage in Medicare Part D plans change after the Inflation Reduction Act (IRA)?In this cross-sectional study of enrollees in Medicare Part D stand-alone and Medicare Advantage plans, from 2019 to 2025 mean deductibles and the proportion of patients with coinsurance for preferred brand-name drugs increased. For stand-alone plans, these increases were observed before and after the IRA changes took effect in 2025, but for Medicare Advantage plans, the changes were abrupt in 2025.The IRA limited annual out-of-pocket costs to $2000 for Medicare Part D beneficiaries, but concurrent design changes by Part D insurers, particularly among Medicare Advantage plans, may lead to higher cost sharing for some beneficiaries who do not reach this limit in 2025.

Corresponding Author: Christopher L. Cai, MD, Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 1620 Tremont St, Ste 3030, Boston, MA 02120 (ccai@bwh.harvard.edu).

Link to the article in your story

We encourage you to link out to this article in your story using the link below. It includes an access token that will give free access to the article for your readers up to one year after publication. (The link will be live after the article publishes and embargo is lifted.)

Please see the article for additional information, including full author list, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

Need more information? Contact us.