BIO, PhRMA Urge Delay In Part B Drug Price Substitution Policy Until AMP Reg Finalized
This article was originally published in The Pink Sheet Daily
BIO and PhRMA urge CMS to delay making reimbursement rate substitutions for Medicare Part B drugs based on comparing ASP to AMP until the agency finalizes its rules on the methodology for calculating AMP. The final AMP rule is expected in 2013.
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CMS does not concur with recommendations from the HHS Office of the Inspector General that it should apply its AMP-based price substitution more broadly for drugs reimbursed by Medicare Part B.
Pharmaceutical industry stakeholders could have to wait another year before Medicaid details how to calculate average manufacturer prices for drugs and drug rebates and how to handle other complex issues from the Affordable Care Act.
A proposed rule on the calculation of average manufacturer price issued Jan. 27 addresses numerous complex issues for the pharmaceutical industry in its 200 pages, including a proposal that manufacturers report AMP based on their actual sales to retail community pharmacies or to wholesalers for drugs distributed to retail community pharmacies.