Medicare Part B Shift To Discourage Prescribing Of Costly New 340 Drugs Weighed By MedPAC
Linking clinical superiority to payments is another recommendations on Medicare reimbursement for separately payable drugs in the hospital outpatient prospective payment system under consideration by the Medicare Payment Advisory Commission.
You may also be interested in...
Medicare’s doubts about trial design for Sage’s postpartum depression therapy suggests even ‘breakthrough’-designated products can struggle with the ‘substantial clinical improvement’ standard for NTAP status. Denial of enhanced payment for Zulresso ends a long winning streak by innovators.
PhRMA is stepping up its advocacy for 340B reform, noting recent reduction in Medicare payments for 340B is encouraging in that it indicates Administration may be open to further change.
The policy is welcomed by biosimilar stakeholders, but amounts to a relatively small increase. To qualify for the revised payment, a biosimilar must have an average sales price that is less than its reference drug’s ASP and not all do.