Global Healthy Living Foundation Peer-Reviewed Research Shows Hidden Risks of the Inflation Reduction Act’s Drug Pricing Reform

Report reveals potential for higher patient costs, worse health outcomes despite lower “fair prices”

UPPER NYACK, N.Y., June 10, 2025–(BUSINESS WIRE)–The Global Healthy Living Foundation (GHLF) has launched a research-backed public education campaign to raise awareness about the unintended consequences of drug pricing reforms under the Inflation Reduction Act (IRA). This initiative stems from a recent peer-reviewed paper co-authored by GHLF’s Chief Science Policy Officer, Dr. Robert Popovian, Pharm.D., MS, published in the Journal of Health Economics and Outcomes Research (JHEOR). It includes a podcast episode, an infographic, and an article aimed at informing patients, caregivers, and policymakers.

“The IRA’s “maximum fair price” (MFP) policy was designed to reduce out-of-pocket costs for Medicare patients. However, it may lead to the opposite: higher out-of-pocket costs and increased health risks for vulnerable patients,” report author Dr. Popovian says

“By suppressing the retail price, CMS is reducing the profit margins and revenue for pharmacy benefit managers (PBMs), which is good. Predictably, the PBMs will not stand pat—they can shift the drug to a higher formulary tier, where patients will pay more out-of-pocket to acquire the medicine so the PBM can protect its profit margin,” said Dr. Popovian in a recent episode of GHLF’s Healthcare Matters podcast.

The study specifically modeled outcomes for two widely used blood thinners, Eliquis and Xarelto. If PBMs reclassify these drugs to higher cost tiers to compensate for lost profit, patients could face an estimated $688 million more in out-of-pocket costs. This cost-shift could result in over 320,000 patients abandoning treatment, potentially leading to 145,000 major cardiovascular events and up to 97,000 deaths.

“This research underscores a serious gap in how drug pricing reforms are being implemented and monitored,” said Dr. Popovian. “Without proper oversight and transparency, policies that were meant to help patients could end up hurting them.”

The GHLF education campaign includes:

• A peer-reviewed paper published in JHEOR: “Could the Inflation Reduction Act Maximum Fair Price Hurt Patients?”

• A patient-friendly article: “Lower Prices, Higher Risk: How Drug Reform Could Backfire on Patients” published on GHLF’s website and supported by social media

• A special podcast episode of Healthcare Matters, co-hosted by Dr. Popovian

• A downloadable infographic explaining the findings at-a-glance