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.
International Price Indexing (IPI) Will Restrict Access
IPI will threaten patients’ access to outpatient infusion facilities across the country, both independent, community-based sites of care and hospital-based sites of care. It will also cause government to ration health care and medications to save money, as we’ve seen in other countries that have instituted price controls.
International Price Indexing (IPI) Will Increase Costs
IPI referencing will disrupt the viability of the lowest-cost care settings available for Part B drugs, sending beneficiaries into hospitals to receive their medications at significantly higher cost to patients and Medicare.
International Price Indexing (IPI) Will Decrease Innovation
IPI will limit the incentive for manufactures and researchers – often smaller start-ups – to continue innovating and researching cutting edge medications, jeopardizing the life-saving medicine patients depend on.
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 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.