The researches find that the The Senate Finance Committee package includes several provisions intended to reduce the amount Medicare, Medicaid, and consumers spend on drugs. It is unclear whether the Senate will ever vote on this package. Still, the bipartisan support shown at the committee meeting for measures contained in the package signals that lawmakers might revisit these ideas; even if the package in its entirety does not progress.
The amount Medicare
Some of the package’s proposals might be consider; for example; as potential offsets needed to allow new spending in a later congressional budget deal or tax bill. The Senate Finance Committee’s legislative package reflects lawmakers’ continued unease about how Medicare purchases medicines; including its paying a premium to average sales price (ASP) for drugs administered by physicians. Drugs in this category include many cancer and rheumatoid arthritis treatments.
Senate Finance Committee Chairman Charles E. Grassley (R-IA) ;said lawmakers are seeking to address incentives in the Medicare Part B program that now favor use of more expensive drugs; even when a less expensive drug could be prescribed. Part B applies a premium to the reported ASP of medicines. (The premium originally was set at 6% of ASP, but subsequent budget cuts have lowered that to about 4.3%.)
More expensive drugs
Oncology groups objected to the Senate Finance Committee’s plan to factor into Medicare Part B’s drug payment the amount pharmaceutical companies have contributed from patient assistance programs, such as coupons and financial support. This change could produce savings of as much as $1.45 billion over a decade; the Congressional Budget Office said in a July 24 report.
In a statement on the Senate Finance bill, COA said the proposed change in Part B reimbursement would lead drugmakers to “reduce or eliminate these critically important” financial assistance programs. In a letter sent Thursday to the Senate Finance Committee; ASCO raised similar concerns about patients. The group also emphasized the potential financial risk for oncology practices. The change proposed in the Senate Finance bill would increase the risk for practices to be “underwater” when providing certain medicines.
“meaning that the practice pays more for the drug than they are reimbursed by Medicare if it does not result in lower list prices as intended;” wrote Howard A. “Skip” Burris III, MD, president of ASCO; in a July 25 letter to Senate Finance. Still; ASCO appeared supportive of other aspects of the Senate Finance bill; including a bid for greater transparency of the flow of discounts to pharmacy benefit managers.