Drug Pricing Legislation: What You Need To Know

With the newly enacted Inflation Reduction Act of 2022 causing drastic changes to the regulations surrounding pharmacies and pharmacists, many are left unsure of how exactly this legislation affects them. To make things easier to understand, we've put together a comprehensive guide on drug pricing legislation to provide critical insight into the Inflation Reduction Act and what it really means for pharmacists and pharmacies.

The Inflation Reduction Act of 2022 is a piece of legislation that was put together to protect the public from the practices of certain pharmacies and pharmacists in setting drug prices. The act requires all pharmacies to adhere to new pricing guidelines and sets limits on how much they can charge for each prescription. It also prevents them from increasing prices on any drugs that are deemed essential, such as those used to treat serious diseases and disorders. Additionally, the act requires pharmacists to provide detailed information about the prices of their medications to consumers in order for them to make an informed decision when purchasing medication.

Some additional provisions include:

• Requiring the Centers for Medicare and Medicaid Services to negotiate the prices of certain drugs under Medicare, beginning in 2026. These drugs are brand-name drugs that do not have other generic equivalents and that account for the greatest Medicare spending.
• Requiring drug manufacturers to issue rebates to the CMS for brand-name drugs without generic equivalents under the Medicare prescription drug benefit that cost $100 or more per year per individual and for which prices increase faster than inflation. Beginning in 2023.
• Caps out-of-pocket spending for Medicare D enrollees at $2,000 (with annual adjustments thereafter) beginning in 2025.
• Limits monthly cost sharing for insulin to $35 for people with Medicare, beginning in 2023.
• Eliminates cost-sharing for adult vaccines covered under Medicare Part D and improves access to adult vaccines in Medicaid and CHIP, beginning in 2023.
• Expands eligibility for full benefits under the Medicare Part D Low-Income Subsidy Program, beginning in 2024.
• Further delays implementation of the Trump Administration’s drug rebate rule, beginning in 2027.

How Will This Affect Pharmacies?

The Inflation Reduction Act of 2022 has the potential to significantly alter the way that pharmacies and pharmacists do business. It is important for them to understand the new regulations, as well as how they might be affected in the long run. Pharmacies may need to adjust their pricing models and increase transparency about drug prices in order to comply with the new laws. Additionally, the legislation could lead to increased competition among pharmacies and pharmacists, as well as changes in how they market their products. Pharmacies should be prepared for potential disruptions and monitor any changes that are made to the law.

The main goal behind the Inflation Reduction Act of 2022 is to protect consumers from rising prescription drug prices and ensure that they have access to affordable medication. With this legislation in place, pharmacists and pharmacies must adapt to meet these new regulations in order to remain compliant and provide their customers with the best possible service. By remaining informed about the changes brought by this law, pharmacists and pharmacies can ensure that they are operating in a way that meets all requirements under the Inflation Reduction Act of 2022.