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CMS Proposes International Pricing Index for Medicare Part B Drug Spending

2019-06-18T14:15:34-04:00October 31st, 2018|Categories: Recent News|Tags: |

CMS Proposes International Pricing Index for Medicare Part B Drug Spending

Increasing competition among private-sector vendors and aligning Medicare payments for drugs with prices that are paid in foreign countries is the focus of a new model to improve Medicare beneficiary access and quality of care and reduce expenditures for specific physician-administered drugs.

The ‘International Pricing Index’ (IPI), announced last week by the U.S Department of Health and Human Services would be phased in over five years from Spring 2019, initially focusing on single source drugs and biologicals as these encompass a high percentage of Part B drug spending.

Under the proposed rule, existing payments for separately billable Part B drugs would move from the average sales price and 6 percent add-on to a ‘Target Payment’ derived from international price index.

CMS is seeking public comments on the potential parameters of the IPI Model. The advance notice of rulemaking (ANPRM) can be accessed from the CMS Newsroom here.

Boston Healthcare is actively monitoring this situation and its potential impact on physicians and pharmaceutical companies.

Comments are due to CMS on Monday, December 31, 2018.

Defining Value in Digital Health

2019-06-18T14:16:21-04:00October 31st, 2018|Categories: Recent News|Tags: |

Defining Value in Digital Health

Team members at Boston Healthcare attended the annual Digital Healthcare Innovation Summit, a meeting place for innovators, investors, payers, providers, policymakers, and advisors to discuss the current and future landscape for digital health. The event covered major areas of digital health, from investment prospects and digital-evidence-based medicine to patient consumerism through technology.

It has never been a better time to be involved in the digital health space; 2018 is set to be the most significant funding year for digital health companies, with over $11B in committed capital. Diagnostics and genomics players that emphasize patient engagement, patient wellness, biometric data acquisition, and clinical workflow capabilities continue to dominate the digital health investment space.

With providers and payers demanding clear value propositions for the adoption and reimbursement of innovative products or services, and for investors becoming more targeted in their approach, evidence development is becoming a clear differentiator for digital therapeutics in an increasingly competitive landscape. Through our work, we have found that evidence to support: value-based pricing payer models; healthcare under- or overutilization; and patient engagement and wellness are often identified as key drivers to adoption by healthcare stakeholders. Types of evidence that produce real-world data will become even more significant over time.

Boston Healthcare continues to monitor the growth and trends in the digital health space to drive commercialization of our clients’ digital health innovations.