Part D Redesign’s Impact on Plan-Manufacturer Contracting

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Summary

Avalere experts discussed how IRA’s Part D redesign may affect plan behavior in Plan Year 2025 and how manufacturers should approach contracting and market access.

As manufacturers continue contracting discussions with Part D plans for Plan Year (PY) 2025, understanding how the Part D benefit is changing and how plans are likely to respond will be essential to preparing a successful contracting strategy. PY 2025 is the first year of the Inflation Reduction Act’s (IRA) major Part D redesign changes, including a new out-of-pocket cap on beneficiary spending, new manufacturer discounts to Medicare, and increased financial liabilities for health plans.

In this webinar, our experts explored these changes and their likely impacts on manufacturers, Part D plans, and the Part D market, with a focus on PY 2025 plan-manufacturer contracting negotiations. Panelists discussed topics including:

  • Provisions of the IRA’s Medicare Part D benefit redesign that will be effective in PY 2025
  • Changes to patient behavior in reaction to the new benefits
  • Part D plans’ likely reactions to the changes, including potential effects on plan offerings, plan types, formulary design, and utilization management
  • How PY 2025 contracting discussions will be affected due to these changes

Moderator

Moderator
Miryam Frieder , Practice Director, Policy

Miryam Frieder co-leads Avalere’s Policy practice, advising a wide range of clients on Medicare Part D and the drug pricing policy environment.

Panelists

Guest Speaker
Amy Larrick President Larrick Consulting, LLC
Guest Speaker
Matt Kazan
Lance Grady Executive Vice President
Life Sciences Strategy & Growth
Neil Lund Senior Advisor
Policy
Shalini Parekh Managing Director
Market Access & Reimbursement
Kylie Stengel Associate Principal
Policy

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