The Inflation Reduction Act: Implications for Medicare spending and access to biologic therapies for chronic rhinosinusitis with nasal polyposis and asthma.

CMS CRS CRSwNP Dupixent Fasenra Inflation Reduction Act Medicare Nucala Part D Xolair benralizumab biologic chronic rhinosinusitis dupilumab mepolizumab nasal polyposis omalizumab

Journal

International forum of allergy & rhinology
ISSN: 2042-6984
Titre abrégé: Int Forum Allergy Rhinol
Pays: United States
ID NLM: 101550261

Informations de publication

Date de publication:
11 Mar 2024
Historique:
received: 16 01 2024
accepted: 25 02 2024
medline: 11 3 2024
pubmed: 11 3 2024
entrez: 11 3 2024
Statut: aheadofprint

Résumé

In 2021, Medicare spending on biologics was $926 million in Part B (FFS) and $1.3 billion in Part D (FFS/MA). Between 2017 and 2021, annual Medicare spending on biologics increased by approximately 200%. Between 2023 and 2025, Medicare Part D OOP costs for biologics will decrease by an estimated 50%-60%.

Identifiants

DOI: 10.1002/alr.23344 PMID: 38465800
pubmed: 38465800
doi: 10.1002/alr.23344
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Commonwealth Fund
Organisme : Arnold Ventures

Informations de copyright

© 2024 ARS-AAOA, LLC.

Références

Rathi VK, Scangas GA, Metson RB, Xiao R, Nshuti L, Dusetzina SB. Out-of-pocket costs of biologic treatments for chronic rhinosinusitis with nasal polyposis in the Medicare population. Int Forum Allergy Rhinol. 2022;12(10):1295-1298. doi:10.1002/alr.22976
Cubanski J, Neuman T, Freed M, Explaining the prescription drug provisions in the Inflation Reduction Act. KFF. 2023. Accessed December 20, 2023. https://www.kff.org/medicare/issue-brief/explaining-the-prescription-drug-provisions-in-the-inflation-reduction-act/
Dattilo LW, Rathi VK, Schlosser RJ, et al. Trends in price, spending, and utilization of omalizumab among Medicare beneficiaries. Int Forum Allergy Rhinol. 2023;13(11):2105-2108. doi:10.1002/alr.23185
Cortese BD, Dusetzina SB, Al Hussein Al Awamlh B, et al. Estimating the impact of the inflation reduction act on the out-of-pocket costs for Medicare beneficiaries with advanced prostate cancer. Urol Pract. 2023;10(5):476-483. doi:10.1097/UPJ.0000000000000425
Johnson M, Nayak RK, Gilstrap L, Dusetzina SB. Estimation of out-of-pocket costs for guideline-directed medical therapy for heart failure under Medicare Part D and the Inflation Reduction Act. JAMA Cardiol. 2023;8(3):299-301. doi:10.1001/jamacardio.2022.5033
U.S. Food and Drug Administration. Highlights of prescribing information: Xolair. 2023. Accessed December 22, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/103976s5242lbl.pdf
U.S. Food and Drug Administration. Highlights of prescribing information: Dupixent. 2023. Accessed December 22, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/761055s054lbl.pdf
U.S. Food and Drug Administration. Highlights of prescribing information: Nucala. 2023. Accessed December 22, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/125526Orig1s021,761122Orig1s011Corrected_lbl.pdf
U.S. Food and Drug Administration. Highlights of prescribing information: Fasenra. 2019. Accessed December 22, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/761070s005lbl.pdf
U.S. Centers for Medicare & Medicaid Services. Drug plan coverage rules. 2024. Accessed December 24, 2023. https://www.medicare.gov/drug-coverage-part-d/what-medicare-part-d-drug-plans-cover/drug-plan-coverage-rules
U.S. Centers for Medicare & Medicaid Services. Quarterly prescription drug plan formulary, pharmacy network, and pricing information. 2023. Accessed December 24, 2023. https://data.cms.gov/provider-summary-by-type-of-service/medicare-part-d-prescribers/quarterly-prescription-drug-plan-formulary-pharmacy-network-and-pricing-information
Wang AA, Rathi VK, Xiao R, et al. Private payer-negotiated prices for FDA-approved biologic treatments for allergic diseases. Int Forum Allergy Rhinol. 2022;12(5):798-801.
Amgen. Amgen reports fourth quarter and 2022 full year financial results. 2023. Accessed December 24, 2023. https://www.amgen.com/newsroom/press-releases/2023/01/amgen-reports-fourth-quarter-and-full-year-2022-financial-results
U.S. Centers for Medicare & Medicaid Services. Medicare Part D spending by drug. 2023. Accessed December 24, 2023. https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug

Auteurs

Vinay K Rathi (VK)

Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
ORCID: 0000-0002-9763-9075

Zachary M Soler (ZM)

Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Rodney J Schlosser (RJ)

Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.

Alan D Workman (AD)

Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
ORCID: 0000-0001-9573-6472

Nikita Chapurin (N)

Department of Otolaryngology-Head & Neck Surgery, University of Florida, Gainesville, Florida, USA.

Nicholas R Rowan (NR)

Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
ORCID: 0000-0003-1296-2648

Stacie B Dusetzina (SB)

Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA.

Classifications MeSH