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Medicare Outpatient Drug Reimbursement Premiums

Medicare Outpatient Drug Reimbursement Premiums



This chart lists the 13 drugs for which CMS' 2005 payment rate represents at least a 40% premium over hospitals' average purchase price for that product. Calculated by "The Pink Sheet" using Government Accountability Office data.



Drug

Average purchase price

CMS 2005 payment rate


Percent Premium

Alpha-1 proteinase inhibitor, 10 mg

$2.35

$3.72

58%

Factor VIII, 1 IU

$0.46

$0.76

65%

Goserelin, 3.6 mg

$201.76

$390.09

93%

Granisetron (injection), 100 mcg

$6.45

$16.20

151%

Granisetron (oral), 1 mg

$24.86

$39.04

57%

Immune globulin I.V. (lyophilized), 1 g

$36.50

$80.68

121%

Immune globulin I.V. (lyophilized), 10 mg

$0.37

$0.75

103%

Immune globulin I.V. (non-lyophilized), 1 g

$50.63

$80.68

59%

Immune globulin I.V. (non-lyophilized), 10 mg

$0.51

$0.75

47%

Leuprolide (for depot suspension), 7.5 mg

$234.05

$543.72

132%

Paclitaxel, 30 mg

$14.45

$79.04

447%

Pamidronate, 30 mg

$58.49

$128.74

120%

Reteplase, 18.1 mg

$846.53

$1,192.09

41%

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