Apremilast and IRA

Feb 10, 2025

In 2022 the Inflation Reduction Act (IRA) introduced sweeping changes to drug pricing, including Medicare’s ability to negotiate prices for select high-expenditures drugs. While the intent is to lower costs for Medicare beneficiaries, the policy raises concerns about unintended consequences for patient access, medical innovation, and future treatment options.

The recent selection of apremilast (Otezla), a widely used treatment for plaque psoriasis and psoriatic arthritis, for the IRA negotiations process exemplifies these concerns. Apremilast is an essential option for patients who cannot tolerate biologics or prefer an oral treatment. The IRA’s focus on cost reduction may lead to restricted formularies and coverage limitations, ultimately reducing treatment options for dermatology patients. Practitioners rely on a broad range of therapies to individualize patient care, and restricting access to certain medication could result in suboptimal treatment outcomes.

Moreover, government price-setting mechanisms risk reducing incentives for manufacturers to invest in research and development, particularly for small-molecule drugs like apremilast, which are subject to negotiations much earlier.

At the Society of Dermatology Physician Associates (SDPA), we support policies that enhance affordability while maintaining access to a wide range of treatment options. Policymakers must carefully assess the long-term impact of drug pricing policies to ensure that cost-saving measures do not come at the expense of patient care.

The debate over IRA drug negotiations is far from over, and with new policy solutions that prioritize innovation and access, SDPA remains committed to advocating for patient-centered solutions.