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Jul 28

Most drugs will see increases in price paid by Medicare

A majority of drugs will be paid with higher prices under Medicare’s average sales price (ASP) payment system for the third quarter of 2008 beginning July 1. At the same time, 223 of the 577 drugs listed, or 38.6%, will decrease in price.

CMS says 28 of the top 50 volume drugs will see price swings of 2% or less. Thirty-two of the top 50 see price increases while the price for one drug will not change at all. The agency attributes ASP decreases impact-ing some drugs to “a number of competitive market factors – multiple manufacturers, alternative therapies, new products, recent generic entrants, or market shifts to lower priced products.”

Price declines: A total of 223 drugs listed un-der the ASP will see a lower price beginning in July. The price will drop by 10% or more for 60 of these drugs, and by at least 5% for another 30 drugs. Another commonly billed HCPCS codes with a decrease in price from the previous quarter not listed in the chart accompanying this story was J2540 (Penicillin g potassium inj., 600,000 units) to $0.632 from $0.936 effective July 1.

Price increases: Prices will increase for 301 drugs, which is higher compared to increases to 205 drugs in the previous quarter. Sixty-four drugs will see price boosts of 10% or more, while an-other 60 drugs received increases of at least 5%.

Source: DecisionHealth’s RBRVS Alert

About Reed Tinsley, CPA

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