Industry Voices—Cancer is always a catastrophe. But one provision of the Inflation Reduction Act is trying to change that

As we grow ever-nearer to election day, more public attention is being cast on our nation’s health policy and each candidate’s vision for Medicare.

Central to that conversation is the Inflation Reduction Act of 2022 (IRA), which sparked heated debate—and a few lawsuits—over its drug price negotiation provisions. But there is another very impactful provision of the IRA that has received far less attention—and it may just prove to be key to sustaining the Biden-Harris administration’s Cancer Moonshot, regardless of what transpires in November.

I am talking about the spending caps introduced for Medicare part D beneficiaries in the so-called “catastrophic” phase of insurance coverage. That is when a Part D beneficiary surpasses an annual out-of-pocket expenditure on oral drugs—set at $8,000 for the year 2024. Prior to the IRA, that patient would be responsible for just 5% of further drug costs. And for most conditions, that was actually pretty reasonable.

For cancer patients, however, 5% can be a very heavy burden, due to the high cost of cancer medications. Now, because of the IRA, Part D enrollees in the catastrophic phase of treatment are only liable for $3,300 per year in 2024, dropping down to $2,000 in 2025. And for cancer patients, this could literally be the difference between life and death.