Posted by Michael Wonder on 09 Jul 2019
CMS’s international pricing model for Medicare Part B drugs: implementation issues
9 July 2019 - For many years, Americans have paid significantly more than the rest of the world for prescription drugs. Medicare spent an estimated $140 billion in 2017 on outpatient prescription drugs, with this large total fuelled by double-digit annual spending growth since 2013.
To lower the Part B portion of drug spending, the Trump Administration has proposed a demonstration project tying Medicare reimbursement for outpatient, physician-administered drugs to international prices.
The proposal would not affect self-administered drugs dispensed by retail pharmacies and reimbursed by private insurance plans under Part D, which are the focus of separate reform initiatives, including significant revisions by the HHS Office of Inspector General to the “safe harbours” regulating manufacturer rebates.
