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How the IRA’s Part B Coinsurance Inflation Adjustments Can Raise Seniors’ Drug Costs
2025-05-21 10:30 UTC by noreply@blogger.com (Adam J. Fein, Ph.D.)

The Inflation Reduction Act (IRA) is triggering increases in Medicare beneficiaries’ spending on their Part B drugs.

Though CMS touts that the IRA’s inflation-based coinsurance adjustments will "lower out-of-pocket costs," the results have been more complicated. Below, we update and expand on our previous analysis.

We find that a growing number of Part B drugs now have inflation-adjusted coinsurance rates that are rising, not falling. In many cases, the rate dips temporarily before snapping back to the standard 20%.

Even more troubling, these fluctuations have led to unexpected increases in patients’ out-of-pocket expenses—even when a drug’s price was declining.

These unpredictable coinsurance shifts are another example of the IRA’s unintended consequences. Rather than enjoying stable or reduced costs, some seniors are finding themselves on a financial rollercoaster.
What’s Next for Retail Pharmacy: Data, Debate, and Disruption.

Don’t miss DCI’s next webinar on June 20, 2025 (12:00–1:30 p.m. ET), featuring Dr. Adam J. Fein and Antonio Ciaccia. We’ll unpack the good, the bad, and the ugly of the pharmacy industry—and explore what it means for you. This dynamic session will blend expert insights and real-time debate. Hope you can join us!
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