The Medicare Payment Advisory Commission (MedPAC), the independent agency that advises Congress on the Medicare program, recently released its June 2019 Data Book: Health Care Spending and the Medicare Program.
This year’s report provides the latest details about the ongoing disruption of the buy-and-bill market in Medicare Part B. As you will see below:
- Physician offices account for a diminishing share of Part B spending, though absolute spending at these sites continues to grow.
- Hospital outpatient settings have been crowding out physician offices. Hospital outpatient departments now account for more than 40% of Part B spending—and an even greater share for oncology products.
What's more, Part B spending has grown much faster than drug prices. The prices paid by Medicare for the top 10 Part B drugs have been growing at low- to mid-single digit rates. Spending has grown due to more beneficiaries and the adoption of newer, higher-priced therapies.
The Trump administration has signaled that it wants Medicare to pay less for Part B drugs. Its primary proposals focus on comparisons to prices paid by other countries. These analyses conveniently overlook the lower drug prices that manufacturers provide to the Medicaid program and 340B hospitals.
It looks like 2020 will not be relaxing times for the buy-and-bill channel.
Drug Channels Institute will host an exclusive live webinar, Drug Channels Outlook: What You Need to Watch in 2020, on Friday, December 13, 2019, from 12 p.m. to 1:00 p.m. ET. Get ready for what will certainly be another year of change for U.S. healthcare. CLICK HERE TO LEARN MORE AND SIGN UP.
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