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Executive Summary

A federal drug cost data base should be created as a reliable source on which to base Medicaid Rx reimbursement reform, the American Society of Hospital Pharmacists (ASHP) recommended in Oct. 20 comments to the Health Care Financing Administration (HCFA). Discussing HCFA's proposed changes in the Medicaid program, ASHP maintained: "HCFA requests suggestions on the use of . . . nationally available sources of drug costs. HCFA should create its own database on these costs." ASHP maintained that "a precedent [exists] for such a data collection effort in the area of parenteral and enteral nutrition therapy reimbursement levels." ASHP said that "information provided by Medicaid agencies would be much more reliable than reliance on Red Book or Blue Book price listings." Calling the Red Book and Blue Book "suspect" sources on which to establish product prices and availability, ASHP asserted: "There is no assurance that these sources, published by private entities, list all suppliers of a drug or that all products listed are legally marketed. Further, manufacturers pay the publishers to advertise their products in Red Book/Blue Book." ASHP maintained there were unanswered questions in each of the alternatives presented by HCFA. Because of these questions, the association of hospital pharmacists did not express a preference for one of the three options -- CIP, PhIP or revised-MAC. Instead, ASHP Executive Vice President Joseph Oddis said: "ASHP remains eager to work with the HCFA in developing a [Medicaid Rx drug reimbursement] system. . . However, we believe that this proposal should be withdrawn in favor of a more comprehensive, equitable and long-term approach to reimbursement."

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