Inflation Reduction Act’s Negative Impact on My Son

TL/DR –

The Inflation Reduction Act (IRA) could undermine the development of new therapies for psychiatric conditions such as schizophrenia due to a disparity in how it treats small and large molecule drugs. The Act protects new large molecule medicines for 13 years, but only grants small molecule drugs, which comprise almost all psychiatric medicines, nine years of protection from government price setting, discouraging investors from funding psychiatric drug research and development. A bipartisan act has been introduced that would provide small molecule drugs the same 13-year protection as biologics, which could restore incentives for small-molecule drug development, benefiting millions of patients living with serious psychiatric conditions.

A Flaw in the Inflation Reduction Act Could Affect Schizophrenia Treatment

As a caregiver for a schizophrenic child, the task of managing his psychiatric symptoms can be daunting. Medications play a crucial role in managing some of these symptoms. New potential drugs appearing on the horizon could offer unprecedented relief. However, a provision lurking within the Inflation Reduction Act (IRA) could possibly halt the development of these promising medications.

The IRA contains a regulation flaw concerning medications in pill form. Should this error remain uncorrected, it could potentially undermine the development of new therapies for psychiatric conditions like schizophrenia, denying patients the possibility of life-changing treatments.

Orally administered medications, or small molecule drugs, are synthesized chemically. Conversely, drugs administered via infusion or IV, or large molecule medicines, are grown from living cell cultures. Although the IRA allows Medicare to negotiate prices for specific brand-name prescription drugs, it does not treat small and large molecule medications equally. The IRA grants new large molecule medicines a 13-year protection, while small molecule drugs are only protected for nine years.

This unequal treatment endangers psychiatric patients, since most psychiatric medications are small molecules, which easily penetrate the blood-brain barrier to address neurological symptoms of these disorders. By offering these treatments four fewer years of price-protection than biologics, the IRA could dissuade biotech investors from funding psychiatric drug development.

A recent survey revealed that over 80% of bioscience firms currently researching mental illness predict the law will impede their R&D. Furthermore, more than 60% plan to move away from the small molecule category due to the high costs of drug development, which averages around $2.6 billion.

The University of Chicago discovered that this unequal incentive structure may result in 79 fewer small molecule medications reaching the market within the next two decades. The IRA could further marginalize psychiatric patients by reinforcing a two-tiered system. The human and societal costs of psychiatric diseases, such as schizophrenia, are significant, cutting the average life expectancy by 15 years and costing the US more than $280 billion annually.

There is still time for Congress to rectify this. The bipartisan EPIC Act introduced by North Carolina Reps. Don Davis and Greg Murphy proposes to grant small molecule drugs the same 13-year protection as biologics, without affecting the IRA’s existing benefits. This small adjustment could ensure that millions of psychiatric patients have access to essential medications.

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