340B Hospitals Playing 'Outsize' Medicare Role In Many Therapeutic Categories
This article was originally published in The Pink Sheet Daily
Analysis supported by drug industry adds to growing research on scale of Medicare Part B payments to hospitals receiving 340B drug discounts.
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Drug discount program creates financial incentive for participating hospitals to prescribe more drugs or more expensive drugs reimbursed by Medicare Part B, resulting in 'substantially higher' spending, a GAO report says.
Bipartisan congressional letters seek relief from HHS but the Trump Administration has taken aim at 340B providers itself and may not be inclined to help.
Value-based contracting in the US is moving toward high-cost drugs for rare disease and away from lower cost chronic treatments as payers plan for the coming pipeline of cell and gene therapies. Marketed gene therapies all have some kind of risk sharing deal in place but further progress on the most innovative payment models is hampered by regulatory and operational challenges. The Centers for Medicare and Medicaid Services has taken a first step toward addressing regulatory obstacles but there is a long way to go.