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Alongside out-of-pocket (OOP) costs reaching significantly increased heights by 2025, prior authorizations for glucagon-like peptide-1 (GLP-1) medications became widespread between 2020 and 2025. With the Inflation Reduction Act (IRA) and efforts to curb off-label use arising as factors for these increases, researchers believe addressing access and affordability of these drugs will remain a challenge.
“Because the IRA introduced an OOP maximum ($2000 in 2025), partly financed by increasing Part D plans’ liability from 15% to 60% of spending in the catastrophic coverage phase, plans may be incentivized to restrict coverage and increase cost…