Preliminary Results from ACCC's Survey on Hospital Outpatient Department Drug Reimbursement Levels
The Association of Community Cancer Centers (ACCC) recently surveyed its hospital pharmacy members to determine if proposed 2007 Medicare payments of average sales price (ASP) +5 percent will be sufficient to cover the drug reimbursement and related pharmacy costs in the hospital outpatient setting. Preliminary results show that for five of the eight oncology and supportive care drugs surveyed, the answer is no: A majority of respondents indicate that their costs will be greater (by more than $100) than the proposed ASP +5 percent Medicare payments.
According to results thus far, a majority of respondents said that the cost of the following drugs combined with the pharmacy-related overhead will be more than the estimated 2007 Medicare payments:
- Neulasta (pegfilgrastim), increments of 6 mg, estimated payment of $2,141.79
74% indicated their Medicare payments would not cover their costs. - Taxotere (docetaxel) 80 mg vial, increments of 20 mg, estimated payment of $1,177.92
68% indicated their Medicare payments would not cover their costs. - Velcade (bortezomib) 3.5 mg, increments of 0.1 mg, estimated payment of $1,043.35
56% indicated their Medicare payments would not cover their costs. - Eloxatin (oxaliplatin), 100 mg, increments of 0.5 mg, estimated payment of $1,694.00
56% indicated their Medicare payments would not cover their costs. - Aranesp (darbepoetin), 200 mcg, increments of 1 mcg, estimated payment of $600.00
50% indicated their Medicare payments would not cover their costs.
For the remaining three drugs in ACCC’s survey, 37 to 42 percent of survey respondents indicated that their drug costs combined with the pharmacy-related overhead would be higher than the estimated 2007 payments.
- Herceptin (trastuzumab), 440 mg, increments of 10 mg, estimated payment of $2,401.96
42% indicated their Medicare payments would not cover their costs. - Rituxan (rituximab), 500 mg, increments of 100 mg, estimated payment of $2,326.15
37% indicated their Medicare payments would not cover their costs. - Avastin (bevacizumab), 400 mg, increments of 10 mg, estimated 2007 of $2,254.40.
37% indicated their Medicare payments would not cover their costs.
ACCC is urging its hospital members to assess how their own pharmacy costs compare to Medicare’s estimated payments for 2007.
ACCC continues to collect data to submit to the Centers for Medicare & Medicaid Services (CMS) and to Congress.
Don Jewler, Communications Director
