Introduction and Objective: The Inflation Reduction Act (IRA), effective January 1, 2023, capped monthly insulin costs for Medicare Part D beneficiaries at $35. Payor restrictions have created barriers to patient access on an innovative Inhaled mealtime Insulin Afrezza driven primarily by high out of pocket costs and prior authorization barriers. This IRA policy shift influenced accessibility and is essential for optimizing patient care. The objective of this analysis was to evaluate Afrezza’s change in Medicare Part D treatment share following the implementation of the IRA cap by comparing total prescription (TRx) distribution between Q4 2022 and Q1 2024.Methods: A retrospective review was conducted using Afrezza TRx payer-type distribution data extracted from IQVIA. TRx shares across payer categories (Cash, Medicaid, Commercial, Medicare Part D) were compared between Q4 2022 and Q1 2024 to assess early IRA-related changes.Results: Afrezza’s Medicare Part D TRx share increased from 15% in Q4 2022 to 30% in Q1 2024, marking the first year under the IRA $35 insulin cap. The modest but measurable rise in Medicare Part D share—coupled with a significant jump in total prescriptions—suggests early traction in affordability-driven access improvement. Other payer categories (Commercial, Medicaid, Cash) showed expected quarter-to-quarter variability but no policy-driven structural changes.Conclusion: The introduction of the IRA insulin cost cap was associated with an early increase in Afrezza utilization among Medicare Part D beneficiaries, evidenced by a rising share of Part D TRx and growing total prescription volume. From a pharmacist’s perspective, the improved affordability meaningfully reduces barriers for patients needing ultra rapid-acting mealtime insulin options. These findings support the value of policy-driven cost reductions in expanding access to innovative insulin delivery systems such as inhaled Afrezza.
J. Nguyen: Other – Post-Doctoral Fellow (Contractor); Current; MannKind Corporation. K. Kaiserman: Employee; Current; MannKind Corporation. Stock/Shareholder; Current; MannKind Corporation. M.E. Castagna: Employee; Current; MannKind Corporation. Stock/Shareholder; Current; MannKind Corporation.
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