IRA & Community Oncology: What to Expect
The Inflation reduction Act (IRA) is dramatically reshaping community oncology, and this article dives deep into the changes. Explore the potential financial risks posed to oncology practices—including those in rural areas—due to drug pricing adjustments and reimbursement cuts. Learn how experts are preparing for these shifts, with a focus on practice sustainability, the role of advocacy, and the impact of specific medications like ibrutinib and pembrolizumab. News Directory 3 provides crucial insights into the evolving landscape of cancer care. Discover what’s next for community oncology.
Inflation Reduction Act: Oncology Practices Face Financial Risks
Updated June 02, 2025
The Inflation Reduction Act (IRA) is poised to considerably reshape the landscape of community oncology, potentially leading to financial strain and practice closures, experts warned at the recent Community Oncology Conference. The discussion, led by Nic Ferreyros of the Community Oncology alliance (COA), centered on how practices are preparing for the IRA’s impact on drug pricing and reimbursement.
The IRA’s Maximum Fair Price (MFP) model could trigger substantial financial losses for oncology practices through Part B reimbursement reductions. Avalere Health studies project reductions nearing 50% for medical oncology and hematology providers. Austin Cox, PharmD, of Florida Cancer Specialists & Research institute, emphasized the considerable challenge and educational needs surrounding prospective versus retrospective reimbursement models.
The IRA’s negotiated drug prices are being rolled out in phases. The initial list included ibrutinib (Imbruvica). Subsequent phases will expand to include drugs such as acalabrutinib (Calquence), palbociclib (Ibrance), pomalidomide (Pomalyst), enzalutamide (Xtandi), pembrolizumab (Keytruda), romiplostim (Nplate), nivolumab (Opdivo), and atezolizumab (Tecentriq).
Barbara McAneny, MD, of New Mexico Oncology Hematology Consultants, voiced concerns about the potential for reduced reimbursement to disincentivize drug development. She noted the lack of incentive to pursue additional indications if patent expiration looms. McAneny also expressed fear that Congress may not have fully considered the consequences for community practices, potentially leading to practice failures.
Rural and underserved areas are particularly vulnerable, potentially displacing patients and increasing overall costs as care shifts to hospital systems. Ferreyros stressed the need for a unified strategy involving lawmaker education, payer engagement, and collaboration with manufacturers and group purchasing organizations to address the challenges of community oncology and drug pricing.
“This is going to be a considerable challenge for all of us,” Cox said.
“My fear, and I have a lot of fear about this, [is] Congress didn’t intend for this to happen. They were not after the practices.They were not after the delivery system.They just thought, ‘Here’s a clever way we can negotiate drug prices lower,’” McAneny said.
What’s next
Practices are urged to understand their cost of care delivery and advocate for transparent payment models. Diversification into other specialties and engagement with lawmakers are also crucial for navigating the changing landscape of community oncology and ensuring sustainability in the face of federal reforms and evolving drug pricing dynamics.