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This time last year, members of Congress were working around the clock to draft and pass the Inflation Reduction Act.

One of their goals was to address government spending on health care. But they specifically didn’t want to discourage research into rare disease treatments, so they exempted some of these so-called orphan drugs from the law.

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Unfortunately, the exemptions aren’t working as intended. Unless Congress acts, the IRA threatens to unravel one of America’s greatest medical and public policy success stories: the explosion of new treatments for patients living with rare diseases.

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