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Policy and practice implications of the Inflation Reduction Act for urology


"The Inflation Reduction Act could impact the livelihoods of a lot of patients by reducing their annual out-of-pocket costs," says Brian Cortese.

In this interview, Brian Cortese highlights implications of findings from the study, “Estimating the impact of the Inflation Reduction Act on the out-of-pocket costs for Medicare beneficiaries with advanced prostate cancer,” for which he served as the lead author. Cortese is a medical student and business student at the Perelman School of Medicine and the Wharton School of Business at the University of Pennsylvania in Philadelphia.

Video Transcript:

They can be placed into 2 buckets. One is policy and then one is clinical practice. In the policy bucket, it highlights that the Inflation Reduction Act could impact the livelihoods of a lot of patients by reducing their annual out-of-pocket costs. And, yes, [they] are implementing this maximum and the cost is going to be distributed; that money doesn't disappear, that cost is taken up by other players, such as Medicare Part D plan sponsors, Medicare itself, as well as some of the pharmaceutical companies that are creating those drugs. So, there is a cost-sharing that's happening, but we have to make sure that we're able to provide these medications to our beneficiaries without totally breaking the bank. If they're unable to afford them anyways, then they're no good.

Second, I think in the practice bucket, it gives clinicians and especially urologists, in this case, something to think about when it comes to treating patients with advanced prostate cancer. Financial toxicity is something I'm very passionate about exploring and seeing how we can reduce it. It's this side effect of certain high priced, maybe specialty medications. Providers need to be acutely aware of how prices of these medications affect their patient's well-being. We tried to be a little bit provocative in this article talking about how certain medication regimens for example, abiraterone with prednisone as well as androgen deprivation therapy, that's 1 of the regimens accepted by the American Urological Association. We tried to say that based off of the out-of-pocket costs, as well as their clinical outcomes, that this medication regimen might honestly be the most cost-effective across all of them. Of course, there's caveats to that. We go into a greater discussion about exactly what are the ups and downs to that statement that we made. But I think it's important that we hypothesize and discuss the implications of what does this look like practically for urologists in the community as well as academic medical centers to prescribe to their patients.

This transcription has been edited for clarity.

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