Medicare Part B Drug Spending

02/20/2020

Medicare Part B Drugs: Pricing and Incentives

Medicare Part B covers infusible and injectable drugs and biologics administered in physician offices and hospital outpatient departments; as well as certain other drugs required by law provided by suppliers such as pharmacies The Part B payment method provides weak incentives for physicians to consider value – that is choose the lowest cost therapy to effectively treat a patient. Moreover, the Medicare program has not implemented various value based practices typically used by commercial insurers and Part D sponsors for self-administered drugs.

Resources for Medicare Part B Drugs: Pricing and Incentives:

Comparison of U.S. and International Prices for Top Medicare Part B Drugs

There is increased interest in how U.S. drug prices compare to those of other developed countries. This ASPE paper focuses on prices charged by drug manufacturers to wholesalers and distributors (commonly referred to as ex-manufacturers prices) for non-retail drugs, which are generally physician-administered. Prices in the United States are 1.8 times higher than in other countries for the top drugs by total expenditures separately paid under Medicare Part B. U.S. prices were higher for most of the drugs included in the analysis, and U.S. prices were more likely to be the highest prices paid among the countries in our study.

Resources for Comparison of U.S. and International Prices for Top Medicare Part B Drugs: