New Report: ASP Rates Do Not Encourage Doctors to Prescribe High-Cost Drugs.

Coalition stresses findings of new report as policymakers consider potentially harmful changes to the Medicare Part B program

Washington, DC, December 18, 2018 --( The Part B Access for Seniors and Physicians (ASP) Coalition welcomed new research from Xcenda, which found that drug payment rates in the Medicare Part B program, as set by the Average Sales Price (ASP), have almost no significant impact on the utilization of high-cost drugs. The report – Medicare Physician-Administered Drugs: Do Providers Choose Treatment Based on Payment Amount? – analyzed physicians’ prescribing behavior through the Medicare Part B program and concluded that the majority of drug utilization in office settings cannot be attributed to high drug prices, but rather other factors.

According to the researchers, “Overall, treatment choice does not appear to be driven by the margin physicians are paid on a drug, indicating that the ASP+6% payment rate does not drive high-cost drug utilization.”

Xcenda examined Medicare Part B claims data for physician-administered drugs received in physician offices to treat rheumatoid arthritis, breast cancer and non-small cell lung cancer to determine whether or not the ASP payment methodology that was implemented by Congress in 2003 creates incentives for physicians to prescribe higher-cost drugs to patients in office settings. Though critics have argued, with little supporting evidence, that the ASP+6% payment rate encourages doctors to prescribe more expensive drugs because the add-on payment is greater, this study indicates that the ASP+6% methodology is not a significant driver of healthcare costs in the United States.

A growing body of research, including this new report, demonstrate that proposals to adjust the ASP+6% system, a policy that is working for patients and physicians, are misguided. The Part B Access for Seniors and Physicians (ASP) Coalition is encouraging lawmakers in Congress and leaders in the Administration to consider the findings of this report when contemplating proposed changes to Medicare Part B, including a recent Centers for Medicare & Medicaid Services proposal to allow Medicare Advantage plans to implement step therapy to manage Part B drugs which, according to the Coalition, “threatens to restrict access and decrease therapy choices for patients.”

To download the report, click here.

About the Part B Access for Seniors and Physicians (ASP) Coalition
The Part B Access for Seniors and Physicians (ASP) Coalition is opposed to harmful changes to the program that would exacerbate health care consolidation, increase access restrictions, decrease choice of therapy, and stifle future innovation for physician-administered treatments.
Part B Access for Seniors and Physicians Coalition
Ellen Almond
(703) 548-1163