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Medicare pays clinics the drug's average sales price plus 6%, so a dearer drug earns the clinic more; replacing the percentage with a flat handling fee removes the incentive to pick the expensive option.
Under Part B, clinician-administered drugs are reimbursed at the average sales price plus 6% (reduced by sequestration). The add-on scales with price, so two equally effective drugs earn a practice very different margins. A flat per-administration fee, set to cover handling and inventory cost, would make the choice between a biosimilar and its reference product, or between two similar checkpoint inhibitors, financially neutral for the prescriber. MedPAC has recommended variants of this for a decade.
Shares 340B Drug Pricing Program, Incentives reward me-too drugs and marginal gains, Prices and value.
Shares 340B Drug Pricing Program, Incentives reward me-too drugs and marginal gains, Prices and value.
Shares Incentives reward me-too drugs and marginal gains, Prices and value, National Cancer Institute (NIH).
Shares 340B Drug Pricing Program, Biosimilar, Prices and value.
Shares Biosimilar, Prices and value.
Shares Incentives reward me-too drugs and marginal gains, Prices and value.
Shares Incentives reward me-too drugs and marginal gains, Prices and value.
Shares Biosimilar, Prices and value.