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MedPAC’s Part B Options Include ‘Value-Based’ Payment During Accelerated Approval

 
• By Michael McCaughan

Medicare Payment Advisory Commission also considering reviving least costly alternative policy in some way, but remains relatively hesitant about changes to ASP+6%.

Unrecognizable diagnostician presenting a value-based health care model. Medical and healthcare concept for finding and improving hospital care quality, reimbursement, private health insurance. - Image
• Source: Shutterstock

The US Medicare Payment Advisory Commission’s initial list of ideas to overhaul payment for drugs in the physician-administered Part B setting includes applying cost-effectiveness benchmarks for new drugs and biologics approved via the Accelerated Approval pathway.

At its 7 October meeting, MedPAC began consideration of proposals to address the “high prices” of drugs covered under Part B. The MedPAC staff offered three potential changes as a...

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