Pay a flat fee for giving a Part B drug instead of 6% of its price
Medicare pays clinics the drug's average sales price plus 6%, so a dearer drug earns the clinic more; replacing the percentage with a flat handling fee removes the incentive to pick the expensive option.
Overview
Under Part B, clinician-administered drugs are reimbursed at the average sales price plus 6% (reduced by sequestration). The add-on scales with price, so two equally effective drugs earn a practice very different margins. A flat per-administration fee, set to cover handling and inventory cost, would make the choice between a biosimilar and its reference product, or between two similar checkpoint inhibitors, financially neutral for the prescriber. MedPAC has recommended variants of this for a decade.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
Pages like this
not linked directly; found by shared links- IdeaPass 340B discounts on cancer drugs through to the patient's bill
Shares 340B Drug Pricing Program, Incentives reward me-too drugs and marginal gains, Prices and value.
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Shares 340B Drug Pricing Program, Incentives reward me-too drugs and marginal gains, Prices and value.
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Shares Incentives reward me-too drugs and marginal gains, National Cancer Institute (NIH), Prices and value.
- CompanyIntas Pharmaceuticals (Accord Healthcare)
Shares Biosimilar, Prices and value.
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Shares Incentives reward me-too drugs and marginal gains, Prices and value.
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Shares Incentives reward me-too drugs and marginal gains, National Cancer Institute (NIH).
- IdeaCap public prices for new cancer drugs to tiers of the ESMO and ASCO value scales
Shares Incentives reward me-too drugs and marginal gains, Prices and value.