Procrit, Aranesp Reimbursement Adjusted; CMS Splits The Difference
Executive Summary
The new payment formula for J&J's Procrit (epoetin alfa) and Amgen's Aranesp (darbepoetin alfa) under the Medicare Hospital Outpatient Prospective Payment System reflects the ratio of dosing used by Medicare providers in chemotherapy patients, CMS said
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“Functional Equivalence” For 2004: Aranesp OPPS Payment Is 78% Of AWP
Medicare will reimburse Amgen's Aranesp at about 78% of AWP under a revised Hospital Outpatient Prospective Payment System rule
“Functional Equivalence” For 2004: Aranesp OPPS Payment Is 78% Of AWP
Medicare will reimburse Amgen's Aranesp at about 78% of AWP under a revised Hospital Outpatient Prospective Payment System rule
Aranesp Medicare reimbursement raised again
Reimbursement rate for Amgen's Aranesp (darbepoetin alpha) for 2004 is $3.88 per microgram under Centers for Medicare & Medicaid Services' 1interim final rule on the hospital outpatient prospective payment system. In November, CMS said it would boost reimbursement from $2.37 to $3.24 per microgram (2"The Pink Sheet" Nov. 10, 2003, p. 14). With the latest raise, Aranesp reimbursement will be 64% higher in 2004 than its current rate. CMS says that, in accordance with the recently passed Medicare law, reimbursement should be "the combined pass-through amount and 3% additional payment" (for a total 88% of AWP) because it is a sole-source drug...