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International Pricing Index Model for Medicare Part B Drugs
The Centers for Medicare and Medicaid Innovation (CMMI) announced a proposed model that would fundamentally alter the Medicare Part B program. Changes include: a mandatory restructuring of provider reimbursement and new administrative middlemen standing between patients and the care they need. Patients with conditions such as Crohn’s Disease, Rheumatoid Arthritis, Multiple Sclerosis, Psoriasis, Psoriatic Arthritis, and Lupus, to name a few who receive treatment at infusion centers will be adversely affected by these changes.
HOW WILL THIS IMPACT ACCESS?
HOW WILL THIS IMPACT COSTS?
- Currently, American patients enjoy access to nearly 90 percent of medications. This proposal would tie America to countries that have less access to these medications and treatment options.
- Middlemen add new bureaucratic barriers between patients and proper treatment, potentially causing delays or shortages for patients in need of immediate intervention.
- Reimbursement changes may accelerate outpatient center consolidation, further limiting patients’ access and options.
- A number of these ideas, including the introduction of administrative middlemen, have been tried in the past. Each time, they have failed to meaningfully control costs.
- The restrictions this proposal will create may limit the treatment options available for patients to manage chronic conditions. Ineffective or inadequate care has been shown to raise program costs in other areas.
- The proposal may stifle innovation, meaning new, breakthrough therapies may be harder to bring to the market.