“We worry that moving Part B drugs into Part D may lead to access issues and force patients into higher cost sites of care,” the groups said.
Third, the White House is proposing to cut Part B drug reimbursement to physicians from the current average sales price plus 6% down to ASP+3% for new drugs.
The groups said that with the budget sequestration currently in place, “the existing Part B payment structure does not adequately cover the costs of obtaining and providing these complex therapies in an outpatient setting. If additional payment cuts or negative changes are implemented or activated through demonstration projects, many patients would be forced into more expensive, less convenient settings to receive their therapies – if an alternative setting is available at all in their areas.”
Finally, the groups mention a proposal that would introduce physician reimbursement that is not tied to drug pricing. But this option is not expanded upon in the Council of Economic Advisors report.