The Prescription IRA Law: Should You Care about it as an MSL?  

If you’re online, the odds of you coming across something regarding drug pricing are very high. The landscape of how drugs are priced and covered continues to change year to year. I can guarantee this will continue to be a hot topic, especially within Medical Affairs. At the most recent MAPS 2024 conference in Puerto Rico, this was no exception. I was fortunate enough to sit in on a discussion all about how to prepare Medical Affairs colleagues for trends and changes to the health care space, particularly when dealing with the new prescription drug law, the Inflation Reduction Act.  

The Inflation Reduction Act, or IRA, was signed and passed in the second half of 2022. Ultimately the law was aimed to help battle rising drug prices and includes several provisions to lower prescription drug costs while also reducing drug spending by the federal government via active price negotiations. This law is super complex and extensive so if you want to learn more, I recommend checking out the US Department of Health and Human Services website. Rather I want to focus on how this could transform what our MSL colleagues are asked to cover, if at all.  

One obvious change is that this could cause significant revenue losses to many drug manufacturers. In turn, this could cause many companies to make decisions on drugs in development based on the money it could generate. Research and development teams are having to completely rethink how and what they invest in.  

A couple of questions quickly come to mind for my MSL friends. Could this mean you may be working with a much smaller pipeline than you’re used to, causing less “job security” and tenure? We may see compounds fall off or companies decide to discontinue trial due to pricing concerns.  

Another question that comes to mind is, are we going to see a decrease in the amount of MSLs that companies want to hire? If there is less of a pipeline, why do we need teams of 20+ MSLs?  

The final and most significant question raised during the MAPS session was one on which we, as participants, couldn’t reach consensus. That was, are MSLs going to have to take on more payor conversations with HCPs as the discussion starts to seep into conversations? Will HCPs be asking more about drug pricing versus just raw data? Some panelists felt that the MSLs needed to be trained heavily on how to have more payor and real-world evidence discussions. That we would see this become more prevalent in the years to come. Others, however, strongly disagreed with this statement. Rather, the need for true Managed Care Liaisons was going to rise as this is such a hefty topic, we need more dedicated employees to cover the payor space specifically.  

Ultimately, this is a very new law! We still don’t know the true effects that it could have on the healthcare and Medical Affairs setting. Currently, it brings up more questions than answers, but as an MSL, you absolutely should care and be watching what impacts the IRA law will have in the overall Medical Affairs landscape.  

I look forward to seeing how this plays out and am always watching the trends play out. Have you noticed any already in your organization? We’d love to hear your thoughts!