Part B Drug Payment Change: Understanding the Implications for Pharma

Over the last six months, the Centers for Medicare & Medicaid Services (CMS) has hinted at changes in drug pricing, driven by their assertion that physician-drugs administered under Medicare Part B were potentially incentivizing providers to use more expensive medications.  It wasn’t until the proposed rule, known as the Part B Drug Payment Model, released on March 8th that we got a sense of just how big a change they were considering.  Using a nationwide, mandatory payment model, CMS is upending the Part B payment system for drugs by proposing to test changes in the add-on payment as well as introducing value-based payment tools and strategies like indication-specific pricing and outcomes-based risk adjustment.  Such a program represents the biggest proposed change in Medicare drug reimbursement in years.

Our featured speakers, Amanda Forys and Jennifer Snow, recorded a live webinar on March 28, 2016 and provided insights on the Part B Drug Payment Model. They focused on what’s known about the proposed Medicare Part B drug payment model and what the implications are for pharmaceutical manufacturers. Ms. Forys and Ms. Snow also shared strategies on how manufacturers will have to evolve to demonstrate product value.