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Cost-Related Medication Nonadherence After the Inflation Reduction Act
Lucas X Marinacci1,2, Stephen Mein1,2,3, Benjamin N Rome4
1Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
JAMA Internal Medicine
|March 9, 2026
Summary
The Inflation Reduction Act (IRA) reduced medication nonadherence for Medicare beneficiaries by capping out-of-pocket drug costs. These early improvements in prescription affordability may enhance chronic disease management.
Area of Science:
- Health Economics
- Public Health Policy
- Pharmaceutical Policy
Background:
- High prescription drug costs are a significant national issue, impacting medication adherence and patient health outcomes.
- The Inflation Reduction Act (IRA) enacted reforms to improve medication affordability, but its effect on adherence was previously unquantified.
Purpose of the Study:
- To assess the association between the IRA's 2024 prescription drug provisions and cost-related medication nonadherence.
- To evaluate the impact of these provisions on healthcare-related financial strain.
Main Methods:
- A quasi-experimental, difference-in-differences analysis was conducted using data from the 2021-2024 National Health Interview Survey.
- Adults aged 62-67 enrolled in Medicare Part D (intervention) or private insurance (comparator) were analyzed, excluding specific high-risk groups due to existing protections.
Main Results:
- Following the IRA's 2024 provisions, cost-related medication nonadherence decreased by 4.9 percentage points among Medicare beneficiaries compared to the control group.
- The reduction was more pronounced in Medicare beneficiaries with multiple chronic conditions (-7.8 pp).
- No significant changes were observed in healthcare-related financial strain.
Conclusions:
- The IRA's 2024 prescription drug provisions were associated with a reduction in cost-related medication nonadherence for eligible Medicare beneficiaries.
- These initial findings suggest potential positive implications for chronic disease management and future health outcomes.
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