Keeping Oral ESRD Drugs Out Of Bundled Payment Could Save Medicare Up To $4 Bil. By 2026 – CBO
This article was originally published in The Pink Sheet Daily
The Congressional Budget Office projects it will be less expensive for Medicare Part D to continue covering oral drugs used in treating end-stage renal disease because market forces will drive down costs once generic competition arrives in 2014, rather than include them in the Part B bundled payment for ESRD treatment.
You may also be interested in...
Rep. Peter Welch introduces a bill that would overturn a provision in the American Taxpayer Relief Act delaying the bundling of oral-only drugs for ESRD treatment, such as Amgen’s Sensipar, until 2016.
In legislation passed by both chambers of Congress Jan. 1, the cost of a one-year reprieve from sharp cuts to Medicare physician payments, scheduled to begin in 2013, would be offset by a reduction in Medicare’s bundled payment for end-stage renal disease. The reduced payment would take into account a drop in the use of erythropoiesis-stimulating agents observed over the last several years.
Heavily rebated drugs may already be meeting the price goals established by the Senate legislation. As a result, price negotiation for drugs covered under Part B are likely to yield greater savings to the Medicare program than Part D.