ISPOR 2025: Exploring sessions on drug pricing and the Inflation Reduction Act

With drug pricing firmly in the spotlight, the ISPOR—The Professional Society for Health Economics and Outcomes Research (ISPOR) 2025 conference (May 13–16, 2025, Montreal, Canada) arrives at a critical moment for health economics, health technology assessment (HTA), and policy communities. As debates around affordability and the Inflation Reduction Act (IRA) intensify, we preview some of the most anticipated sessions tackling these pressing topics at this year’s conference.

Selected sessions

As highlighted by Laura Pizzi in her interview with The Evidence Base, this year’s discussions will center on key themes in government policy related to pricing, reimbursement, and access—particularly the US Medicare Drug Price Negotiation (MDPN) program, mandated under the IRA. The sessions will explore what has been learned from the first 10 drugs assessed, how those insights can inform and improve the process moving forward, and what changes are needed to ensure that HEOR plays a central role in pricing decisions.

Plenary Session: Drug Price Controls—What Are the Unintended Consequences to Innovation?

Date and time: May 14, 8:30am – 9:45am
Moderator: Gregory Daniel (Eli Lilly and Company)
Speakers: Virginia Lee Acha (Merck), Graham Cookson (Office of Health Economics), Sean D Sullivan (University of Washington), Darius Lakdawalla (University of Southern California)

Opening ISPOR 2025, the first plenary session will examine the impact of price limits on innovation, market availability, and the daily experiences of pharmacy providers. It will also spotlight opportunities for HEOR experts to contribute to more balanced, evidence-based policymaking across different stakeholder groups.

What’s Next? Year 1 Learnings of Evidence Planning for IRA Drug Price Negotiation

Date and time: May 14, 10:15am – 11:15am
Moderator: Taylor T Schwartz (Avalere)
Speakers: Peter Neumann (Tufts Medical Center), Michael Ciarametaro (Avalere Health), Russ Montgomery (GSK US)

This issue panel will explore early insights from the first year of Medicare drug price negotiations following the IRA. Experts will discuss key drivers behind the first maximum fair prices (MFPs), the role of value evidence, and strategic considerations for manufacturers preparing for future negotiations, offering practical guidance based on the initial outcomes and evolving CMS processes.

Medicare Price Negotiation of Part B Drugs: Implications for Provider Reimbursement and Commercial Spillover

Date and time: May 14, 1:45pm – 2:45pm
Moderator: Sean D Sullivan (University of Washington)
Speakers: Inma Hernandez (UCSD), Kristi Martin (Camber Collective), Ramesh Srinivasan (McKesson Corporation)

Medicare will begin negotiating prices for physician-administered drugs in 2026, with implementation set for 2028. This transition from reimbursement based on average sales price (ASP) to lower negotiated prices is expected to reduce provider mark-ups in both Medicare and commercial markets, given ASP’s influence on private-sector reimbursement.

Harnessing AI and RWE: Developing Integrated Evidence Strategies for Market Access in the IRA Era

Date and time: May 14, 3:00pm – 3:30pm
Speakers: Jacqueline Vanderpuye-Orgle (Parexel), Matthew Gordon (Parexel)

This session aims to demonstrate how integrated evidence planning (IEP), supported by real-world evidence (RWE) and AI-enabled tools, can optimize clinical development and market access—especially in light of the IRA. Through case studies, attendees will explore how RWE and AI can be embedded across the product lifecycle to enhance strategy, execution, and outcomes.

Navigating the Evolving Landscape of US Healthcare Policy Reforms: Implications for Drug Pricing and Access, Health Equity, and Healthcare Research

Date and time: May 14, 3:15pm – 4:15pm
Moderator: Elisabeth A Fenwick (OPEN Health HEOR & Market Access)
Speakers: Anton Avanceña (The University of Texas at Austin), C Daniel Mullins (University of Maryland School of Pharmacy), Grace E Fox (OPEN Health HEOR & Market Access), Julie Patterson (National Pharmaceutical Council)

This symposium will examine how evolving US drug pricing and access policies under the new administration may shape the future of healthcare. With a focus on health equity, research, and global market implications, experts will provide forward-looking insights and practical guidance for navigating policy shifts that are set to influence healthcare systems worldwide.

Balancing Innovation and Affordability: A Roadmap for Navigating State Drug-Pricing Boards

Date and time: May 14, 5:00pm – 6:00pm
Moderator: Scott Ramsey (Fred Hutchinson Cancer Research Center)
Speakers: William V Padula (University of Southern California), Chad Patel (AESARA)

As Prescription Drug Affordability Boards (PDABs) reshape drug pricing at the US state level, this session will offer a forward-looking view of how stakeholders can navigate evolving affordability reviews and reimbursement limits. With case examples from Colorado and Maryland, speakers will share practical strategies for evidence generation, engagement, and balancing innovation, access, and affordability in a rapidly changing policy environment.

IRA Under Trump: What Is Next?

Date and time: May 14, 10:15am – 11:15am
Moderator: Michael Ciarametaro (Avalere Health)
Speakers: Lisa Joldersma (Avalere Health), Ulrich Neumann (Johnson & Johnson)

This Issue Panel will explore potential shifts to the IRA under a new Trump administration and Republican Congress, including changes to the MDPN program and Part D redesign. Experts will assess the implications for value demonstration, access, and innovation, examining how evolving policy could reshape evidence requirements, pricing strategies, and the future of biopharmaceutical development in the US.

Is IRA Becoming America’s HTA?

Date and time: May 15, 11:45am – 12:15pm
Speakers: Priti Jhingran (Genesis Research Group), Adam Weston (Genesis Research Group)

Building on discussions of IRA policy shifts at the conference, this session takes a closer look at how the MDPN program mirrors global HTA practices. Speakers will compare the MFP process to established HTAs, explore its impact on branded product lifecycles, and outline strategic, evidence-based approaches manufacturers must adopt to navigate this evolving US pricing landscape.

To What Extent Will the Inflation Reduction Act (IRA) Impact Innovation and Access to Rare Disease Treatments—Did the IRA Temporarily Spook Industry or Will It Have a Permanent Influence?

Date and time: May 15, 1:45pm – 2:45pm
Moderator: Kate Hanman (Costello Medical)
Speakers: Richard Xie (RA Capital Management), Sara Hovland (Chiesi), John O'Brien (National Pharmaceutical Council)

The introduction of the IRA raised concerns among rare disease stakeholders, given its limited exemption for orphan drugs. This session will revisit those concerns 3 years on from the signing of the IRA, assessing whether the feared decline in investment and access has materialized or been overstated. Panelists will explore evolving industry responses, policy implications, and what lies ahead for rare disease innovation and access.

Moving Beyond Market Access to Patient Access: What Are the Unintended Consequences of the Inflation Reduction Act (IRA)/Drug Price Negotiation (DPN)?

Date and time: May 15, 5:00pm – 6:00pm
Moderator: Jennifer Whiteley (Oracle Health & Life Sciences)
Speakers: Joe Vandigo (Applied Patient Experience), Ravinder Dhawan (Merck Sharp & Dohme International Service BV), Jessica Daw (Sentara Health Plans)

This session will take a step back to assess the broader system-wide impact of IRA and the MDPN program – examining how these policies are affecting patients, payers, and industry, and what strategies can help mitigate unintended consequences while supporting sustainable access and innovation.

Pharmaceutical Policy Provisions of the Inflation Reduction Act: Beyond Drug Negotiation

Date and time: May 15, 5:00pm – 6:00pm
Moderator: Inma Hernandez (UCSD)
Speakers: Kelly Anderson (University of Colorado Anschutz Medical Campus), Aryana Sepassi (University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences), Julie Patterson (National Pharmaceutical Council)

This panel will delve into key Medicare Part D reforms introduced under the IRA. Speakers will examine the real-world impact of provisions such as the $2000 out-of-pocket cap, insulin copayment limits, and payment smoothing. Drawing on new data, the session will explore both the benefits and potential unintended consequences of these changes to offer practical insights into implementation challenges and what they mean for patient affordability and access.

Prescription Drug Affordability Boards (PDABs): Are There Opportunities for Robust and Transparent Engagement?

Date and time: May 16, 8:00am – 9:00am
Moderator: Elaine Tate (Cencora)
Speakers: Andrew York (Maryland Prescription Drug Affordability Board), Tiffany Westrich-Robertson (International Foundation for Arthritis), Justin Nedzesky (Neurocrine Biosciences), Kathryn Chandra (Genentech USA, Inc.)

This panel shifts focus to how stakeholders, in particular patient groups and manufacturers, can engage more effectively in the process. Using Maryland’s PDAB as a case study, panelists will share practical insights on fostering transparent, fair, and inclusive dialogue. Attendees should gain a deeper understanding of how to navigate PDAB engagement to ensure patient access is meaningfully represented in affordability reviews.

Navigating Complexities in Calculating Therapeutic Alternative Starting Points in CMS Data

Date and time: May 16, 8:00am – 9:00am
Moderator: Sarah Moselle (Avalere)
Speakers: Shanthy Krishnarajah (Johnson and Johnson), Neil Lund (Avalere Health), Jordan T Banks (Avalere Health)

In this panel, speakers will discuss the complexities of using Centers for Medicare & Medicaid Services (CMS) claims data in IRA MDPN program, focusing on challenges unique to product types, data structures, and therapeutic alternatives. Panelists will examine issues such as estimating days supply, diagnosing without claim-level data, and combination therapies. Through expert discussion, the session will highlight innovative approaches to improve data accuracy and transparency, supporting fairer, more informed pricing decisions for both Part B and Part D products.

Latest research in drug pricing and the Inflation Reduction Act

ISPOR 2025 will also highlight numerous research posters that extend and deepen the themes explored in the sessions.

Health Policies and Process of Care: Examples From Europe, USA, and Canada

Date and time: May 16, 10:00am – 11:00am
Moderator: Yifei Liu (The University of Missouri-Kansas City School of Pharmacy)

In this Podium Session, leading research abstracts, chosen by the Research Review Committee, will be presented orally by their authors. Research includes:

• Implementation of the IRA: Evolving Perspectives from US Stakeholders – Jessica Counihan (Trinity Life Sciences)
• Characteristics of RWE used in Regulatory Decision-Making for Marketing Authorization Applications (MAAs) – Shivani Aggarwal (Landmark Science, Inc,)
• Balancing Innovation and Affordability: Analyzing the Cost of Drugs for Rare Diseases in Canada – Cherry Chan (MORSE Consulting, Inc.

Other posters of interest include:

• Insight into Approvals, Marketing, and Pricing of New Medicines 2018 to 2022 – Blake Wladyka (Patented Medicine Prices Review Board)
• Are Commercial Insurance Premiums Associated With the 340B Drug Pricing Program? – James Motyka (National Pharmaceutical Council)
• Emerging Trends in List Price Adjustment Strategies Following Implementation of the Inflation Reduction Act – Kevin Brooks (Red Nucleus)
• Navigating the IRA: Impact of Medicare Part B Rebates on Drug Pricing and Manufacturer Strategies – Brett Gardiner (Access Infinity)
• The Emerging Potential of International Reference Pricing (IRP) in the US: An Analysis of Trends, Challenges, Opportunities and learnings from Europe – Evie Cooke (Cogentia)
• Assessing the Impact of the United States (US) Inflation Reduction Act (IRA) Regulations on Investment Incentives for Orphan Disease Drug Development – Naoko Ronquest (RTI Health Solutions)
• The Changing Impact of the Inflation Reduction Act on Payer Utilization Management- Insights from an Ongoing Quantitative Survey – Varun Saxena (Clarivate)
• Cost-Effectiveness of Sotagliflozin for Patients With Type 1 Diabetes and Chronic Kidney Disease, With and Without Dynamic Pricing – Jason Shafrin (FTI Consulting)
• Evaluating the ICER Special Report in the Context of Medicare Drug Price Negotiations: Implications for Manufacturer Pricing and Evidence Strategies – Breyanne Bannister (Lumanity)
• Value-Based Pricing and Budget Impact Analysis for Multi-Indication Drugs: A Case Study of Oncology Medications – Ahmed Mehdi Baida (faculte de pharmacie alger)
• Factors Affecting Pricing And Reimbursement for Pharmaceuticals in Southeast Asian Countries – Peeyush Potdar (eQuantX Pharma Analytics Solutions)
• The Inflation Reduction Act: Evaluating Impact on Medicare Drug Pricing, Innovation, and Access to Therapies – Mir Sohail Fazeli (Evidinno Outcomes Research)
• What Generalized Cost Effectiveness Analysis (GCEA) Reveals About the Applicability of Foreign Reference Pricing in Medicare Price Negotiation in the US – Richard Xie (RA Capital Management)
• Integrating Dynamic Pricing Into Cost-Effectiveness Models: Implications for US-Based Drug Evaluations – Dominique Seo (Center for Innovation & Value Research)
• Learnings from State and Federal Drug Pricing Negotiations Across the United States: the Impact of Prescription Drug Affordability Boards – Aaditya Rawal (Costello Medical)

Coverage by The Evidence Base

The Evidence Base will be providing exclusive coverage of ISPOR 2025 (May 13–15, Montreal, Canada), including daily session highlights and in-depth features on all three plenaries. Register on The Evidence Base and follow us on LinkedIn to stay informed and up to date with the latest insights and developments from the conference.