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Inflation Reduction Act (IRA)

A 2022 federal law that, for the first time, allows Medicare to negotiate prices directly with drug manufacturers for select high-cost medications.

How It Works

The Inflation Reduction Act of 2022 is the most significant drug pricing reform in decades. Key provisions include: (1) Medicare can negotiate prices for a growing number of drugs — starting with 10 drugs in 2026 and expanding to 20 per year by 2029; (2) manufacturers that raise prices faster than inflation must pay rebates back to Medicare; (3) Part D out-of-pocket costs are capped at $2,000 per year starting in 2025; and (4) insulin copays are capped at $35 per month for Medicare beneficiaries. The first 10 drugs selected for negotiation include Eliquis, Jardiance, Xarelto, and Januvia — representing billions in annual Medicare spending.

Related Terms

  • Medicare Part DThe prescription drug benefit within Medicare, covering outpatient medications for 50+ million Americans aged 65+ and those with disabilities.
  • Drug Price IncreaseWhen a manufacturer raises the list price (WAC) of an existing drug — a common practice that has driven much of the growth in U.S. drug spending.
  • Medicare Drug NegotiationThe process under the Inflation Reduction Act where CMS negotiates a "maximum fair price" directly with manufacturers for select high-cost Medicare drugs.

About This Definition

This definition is part of the DrugPrice Drug Pricing Glossary34 terms explaining how prescription drug pricing works in the United States. All definitions are written in plain language for patients, caregivers, journalists, and healthcare professionals.