Last week, CMS officially scrapped its ill-conceived Medicare Part B Payment Model "experiment." That's good news (for now) for oncology practices that buy-and-bill provider-administered drugs. (Click here to follow the buy-and-bill dollar.)
Today's rerun highlights specialty pharmacies' significant role in disrupting this buy-and-bill channel. As a companion article, check out The Decline and Fall of Physician Buy-and-Bill For Specialty Drugs, which shows how higher-cost hospital outpatient settings have been crowding out lower-cost physician offices.
Don't let the CMS move make you complacent. Buy-and-bill will be changing. (Click here to see the original post and comments from July 2016.)
The distribution channel for provider-administered oncology drugs is undergoing significant change—notwithstanding the Centers for Medicare & Medicaid Services’ (CMS) misguided and controversial Part B Drug Payment Model.
As you will see below, pharmacies—via white and brown bagging—have displaced buy-and-bill distribution channels for about one-quarter of oncology products. For the remaining purchases, community oncologists still rely on traditional buy-and-bill wholesale distribution channels. Hospital-based practices, however, are more likely to source products from the hospital’s pharmacy.
This shift has important implications for manufacturers’ channel strategies, specialty pharmacies’ business growth, distributors’ share of channel volume, and the expansion of 340B pricing to non-340B providers. When you eliminate the impossible, whatever remains, however improbable, must be the truth.
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