(B-076) The Inflation Reduction Act Lowers Out-of-Pocket Costs for Orally-Administered Blood Cancer Therapies

Background: The Inflation Reduction Act of 2022 (IRA) redesigned the Medicare Part D benefit for self-administered prescription drugs, placing an annual limit on beneficiaries’ out-of-pocket (OOP) spending of approximately $3,300 in 2024 and $2,000 in 2025.

Objectives: To compare pre- (2023) and post-IRA (2024-2025) OOP costs of orally administered therapies for 3 common blood cancers: chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), and multiple myeloma (MM).

Methods: In this descriptive study, we used National Comprehensive Cancer Network guidelines to identify orally administered therapies indicated to treat CML (6 products), CLL (6), and MM (5). We identified the retail price of each drug using the Medicare Part D Plan Finder, selecting the plan with the lowest total costs for zip code 37205. We used the plan benefit design from the Medicare Prescription Drug Plan Formulary files to calculate OOP costs for 12 prescription fills of each anticancer medication in each year, assuming no other medication use.

Results: There were 3,778 Medicare Part D plans in 2025 across the US. Nearly all plans (99.9%) required beneficiaries to pay a percentage of the drug’s price (coinsurance), ranging from 5% to 25%. Due to high retail costs (exceeding $10,000/month), beneficiaries in 2025 will meet the OOP cap of $2,000 with their first fill of most anticancer medications. The estimated annual OOP savings from pre- to post-IRA, ranged from $6,686 (nilotinib for CML annual OOP costs including premiums: $8,806 in 2023; $3,547 in 2024; $2,120 in 2025) to $22,716 (selinexor for MM: $24,836 in 2023; $3,561 in 2024; $2,120 in 2025). Findings were consistent across drugs, with the exception of generic imatinib, where annual OOP costs increased from $514 in 2023 to $586 in 2025.

Conclusions: We found that the IRA’s redesign of the Medicare Part D prescription drug benefit substantially decreased the OOP cost burden of beneficiaries who fill prescriptions of high-cost anticancer therapies. Future research is needed to understand how these reduced costs will impact medication initiation, adherence, and cancer outcomes.