The most controversial aspect of the proposal centers on the implementation of a nationwide experiment, scheduled for 2017, to test multiple methods of slowing drug spending in physicians’ offices, clinics, hospitals and cancer infusion centers. The aim of the proposal is to more accurately tie payments to efficiency of drugs to maintain quality and slow spending in Medicare Part B.
One of the proposed tactics would allow Medicare to group together therapeutically similar drugs and set a benchmark price it would pay for all drugs in that category.
Although the proposal prohibits providers from charging patients the difference in cost between the drug’s sales price and a benchmark payment, critics see this tactic as government price-setting and have expressed concerns over Medicare choosing which drugs to group together.
While Republicans have introduced legislation to block the regulation if the proposal is finalized, Democrats are split on the issue, with only half issuing a letter of support. Given the controversy over the plan, most are unsure what the final version will look like.
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