Richard H. Hughes, IV, William (Will) Walters, and Spreeha Choudhury, attorneys in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, co-authored an article in Health Affairs, titled “Vaccines Deserve Immunity from the IRA’s Pricing Provisions.”
Following is an excerpt:
In addition to its widely known drug pricing provisions, the Inflation Reduction Act (IRA) has made important changes to how vaccines are covered under Medicare and Medicaid. To ensure better vaccine access, the IRA has mandated the elimination of out-of-pocket expenses for Medicare Part D beneficiaries and a federal matching incentive for states to close a gap in vaccine coverage under traditional Medicaid (Medicaid expansion programs are already required to provide this coverage under the Affordable Care Act). Once implemented, these changes could ensure that nine out of 10 Americans have coverage of recommended vaccines.
However, vaccines are subject to some of the same IRA provisions as drugs, including the IRA’s Part D inflationary rebate provision and the price negotiation provisions under Part D and B. Subjecting vaccines to these provisions highlights Congress’ failure to recognize that vaccine costs are already subject to higher scrutiny and that it is desirable for vaccines to be highly used in Medicare. Moreover, the IRA’s drug provisions are incongruent with the aims of optimizing vaccine access and uptake.
