Community Oncology: Awareness v Action in the Face of the IRA

Article

Community Oncology: Awareness v Action in the Face of the IRA

September 18, 2024
Authors
Topics

The Inflation Reduction Act (IRA) will significantly impact community oncology practice financials. As we approach this shift, our latest research from the 2024 Community Oncology Report reveals a current gap between awareness and action.

Figure 1: Community Oncology Actions to Address Any Potential Impact of the IRA   Source: HMP Market Access Insights 2024 Community, and Payer Oncology Trend Report.

The Inflation Reduction Act (IRA): Are Community Oncology Practices Prepared?

The IRA brings sweeping changes, including new drug negotiation policies and Part D plan redesign. These reforms will have far-reaching effects on community oncology practices. One key impact? Lower drug prices resulting from Centers for Medicare & Medicaid Services (CMS) negotiations could reduce drug revenues—a crucial source of financial stability for many community oncology practices relying on buy-and-bill revenue. Our 2024 Community Oncology Report highlights the level of IRA awareness among community oncology practices as well as initial actions to address potential impacts.  

IRA awareness is high in community oncology practices, but action lags:

  • Eighty-five percent of community oncology practices are aware of potential financial impacts of the IRA; however, only 62% are actively taking steps to prepare.  
  • Surprisingly, 36% of practices remain in a "watch and wait" phase.

Why the Delay in Action?  

The complexity and uncertainty surrounding the IRA's implementation are causing many community oncology practices to pause. They understand that action is necessary, but struggle with quantifying the precise impacts and developing flexible strategies to adapt.  

Initial community practice responses remain limited to discussions among leadership including:

  • Practices dispensing oral medications closely monitoring pharmacy benefit managers’ (PBMs') evolving reimbursement strategies.  
  • Growing attention to Part D plan changes, particularly regarding patient out-of-pocket costs.

What's Next?  

As IRA's implementation continues, it's crucial for community oncology practices to move from awareness to action.  

Stay tuned for our upcoming 2024 Landscape Report Part 2, set to release in October, for an even deeper dive into the expected impact of the IRA on providers and the implications for manufacturers.  

In the meantime, I'm here to answer your questions and would love to hear from you! Send me a note at ebijesse@hmplgobal.com.  

The Latest

Our 2024-2025 Oncology Clinical Pathways Report, set for release in December, will provide insights into the most impactful pathways and key factors manufacturers should assess as the oncology pathways landscape continues to evolve.
Article
Unlocking Oncology Pathway Impact: Beyond Lives Covered to Real Prescribing Influence

As Oncology pathway programs continue to become more prominent in the marketplace, manufacturers are being challenged to assess how influential a specific pathway is.

Daniel Buchenberger
Podcast
Community Oncology Practice Economics - Podcast Part 3 of 3

In the final part of this 3-part podcast series, HMP Executive Vice President Lee Blansett and special guest John Hennessy—health system, provider and oncology strategist—explore emerging models for success in oncology practice economics.

Lee Blansett
Bispecific Antibodies: A Balancing Act of Promise and Complexity
Article
Bispecific Antibodies: A Balancing Act of Promise and Complexity

Bispecific antibodies have emerged with great promise, but adoption has been slower than expected. This was a key topic discussed by a panel of 5 experts at the October 2024 Association for Value-Based Cancer Care (AVBCC) conference.

Chris Van Denburg