Drug Topics - November 26, 2007 - (Page 10)

10 DRUG TOPICS NOVEMBER 26, 2007 www.drugtopics.com NEWS Roundup Government and Law OIG thinks generics should be subject to Medicaid rebates If manufacturers keep jacking up the prices of their generic drugs, they should be subject to Medicaid rebates, just as brand-name manufacturers are at present. That’s the gist of a new Office of Inspector General report, which reviewed a list of the top 200 generic drugs, ranked by Medicaid reimbursement, from 1991 through 2004. It found that generic drug price increases exceeded the specified statutory inflation factor applicable to brand-name drugs for 35% of the quarterly average manufacturer prices reviewed. Had generic manufacturers been required to pay Medicaid rebates as brand companies are, OIG believes Medicaid would have received $966 million in rebates from them for the products studied during this time period. OIG urged CMS to seek legislation to extend the rebate requirement to generic drugs. Health professionals think Part D has hurt long-term care patients On balance, the Medicare Part D benefit has had an adverse impact on long-term care patients. That’s the conclusion of a new survey of medical directors, pharmacists, nursing directors, and nurse practitioners funded by sanofi-aventis. The survey found that respondents from all four disciplines generally agreed that Part D has had a negative impact on patient access to needed medications, such as dementia drugs. Almost one-fourth of nursing directors reported delays in medication delivery as a result of waiting for prior authorization approval. Many also noted that Part D has resulted in increased costs to their nursing facility because certain medications ordered by prescribers were not covered by residents’ prescription drug plans, forcing the facility to pay for the product. Not doing so would have resulted in significant sanctions. The survey obtained a total of 685 responses. Complete results of the survey can be found in The Senior Care Digest Interdisciplinary Report. To obtain a copy, health professionals should contact their sanofiaventis representative. Database offers NPI and prescriber data PDX-NHIN and Health Market Science have agreed to jointly market the HMS Prescriber Master File, a database of 1.8 million prescriber records. The database will include more than one million National Provider Identifier numbers. PDX customers using the PDX Pharmacy System will gain access to the databases. CMS has announced that, beginning in January, it will require NPI numbers for Medicare billing. Since May, many health plans have required pharmacies to submit both legacy identifiers as well as NPIs to ensure that the claims are paid. NACDS, NCPA slap CMS with suit over AMP While not giving up on a legislative fix, NACDS and NCPA have sued CMS to block the implementation of the average manufacturer price rule for Medicaid. CMS already is requiring drug manufacturers to report prices to CMS, and the pharmacy reimbursement is set to change in January 2008. According to a study from the Government Accountability Office, the new rule may reduce pharmacy reimbursement by an average of 36%. The lawsuit was filed before either Senate or House legislation came up for a vote to block the planned rollout of a CMS Web site listing AMP prices that is expected to be introduced in December. PDPs owe Medicare $4.4 billion for 2006 Medicare Part D prescription drugs plans owe Medicare more than $4 billion, and CMS has no procedure for quickly collecting the money. According to estimates from the Office of the Inspector General, most of the funds owed are profits that sponsors must repay to Medicare as a result of the program’s risksharing requirements. Eighty percent of sponsors owe money to Medicare, because they overestimated the cost of providing the benefit in their bids. The remaining 20% underestimated and are owed for the 2006 benefit year. Most problematic for CMS is its inability to reconcile quickly and collect the overpayments, as well as its poor oversight of programs that overestimate costs. The OIG report recommends improving oversight and passing legislation to reduce the risk-sharing responsibility for CMS. Survey says: Seniors satisfied with Medicare Rx benefit Seniors are satisfied with the Medicare Rx drug benefit, according to a telephone survey conducted in October by Voter Consumer Research Inc. and commissioned by the Medicare Rx Education Network. At a recent press briefing to announce results of the survey, Sandra Tirey, VP, Voter Consumer Research, said that overall satisfac- http://www.drugtopics.com http://www.oig.hhs.gov/oas/reports/region6/60700042.pdf http://www.drugtopics.com/drugtopics/Medicare+%2F+Medicaid/CMS-to-require-NPI-numbers-in-January/ArticleStandard/Article/detail/462564?contextCategoryId=6925 http://www.drugtopics.com/drugtopics/Medicare+Part+D+News/Medicaid-switch-to-AMP-carries-consequences/ArticleStandard/Article/detail/408151

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Drug Topics - November 26, 2007 Contents Cough & Cold Recommendations May Impact Other Products More Novelty OTCs Elbow Onto Store Shelves Medication Reconciliation Policies Incomplete at Many Hospitals Hospitals Regress in Reconciling Drugs in 2006 Latest News Roundup

Drug Topics - November 26, 2007

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