Fact Check: How the Part B International Pricing Index model threatens patient access

Nicole Longo
Nicole Longo March 29, 2019


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PhRMA_FCF_3.26.19_v1.1[3]Since the Department of Health and Human Services (HHS) released the Part B International Pricing Index (IPI) model late last year, there have been a number of inaccurate claims floating around about the proposal’s impact on patients, biopharmaceutical innovation and the U.S. health care system. This week, we are setting the record straight on how the proposal, which would set U.S. prices for Part B medicines based on the prices mandated by foreign governments, would most likely result in restricted access for seniors who rely on Part B for their medicines.

Fact: Every time other countries have set prices, it has resulted in restrictions in access to medicines. The recent report from HHS’ Assistant Secretary for Planning and Evaluation (ASPE) found that all 16 countries evaluated in the report had fewer treatment options than in the United States and patients experienced delays in accessing treatment or were denied innovative medicines that could improve their quality of life. This is concerning given U.S. patients currently have, on average, access to 96 percent of new cancer medicines, while patients living in the countries included in the IPI model have access to only half of those medicines, on average. On top of having fewer options, patients in these countries also have to wait years longer, on average, for these medications than patients in the United States. That’s why a broad range of stakeholders have raised concerns with the IPI model’s impact on patient access to medicines.

In addition to research, numerous patient stories shed light on how access restrictions abroad have led to worse health outcomes. A recent Independent article highlights how patients as young as 25 years old are refused a promising multiple sclerosis treatment that can delay the disease and give patients an additional seven years of independence before needing a wheelchair. One U.K. patient shared the harsh reality of this system, explaining “You can’t imagine what it’s like to get a diagnosis and to be told there’s nothing for you.” Its patient stories like these that the Administration must consider before opening the floodgates to flawed foreign pricing policies.

The International Pricing Index Model is the wrong prescription for Medicare and America’s seniors. The Administration must stop the IPI proposal and instead focus on the right prescription for Medicare Part B. Policymakers should pursue changes that fix misaligned incentives, such as those seen in the 340B program, and support the continued shift toward value-driven care. Approaches like these will ensure the Part B program continues to fulfill its promise to seniors. 

Find out more about how the IPI Model is the wrong prescription for Medicare at PrescriptionForMedicare.org.

Topics: Access, Medicare, Part B, CMMI, Prescription for Medicare, International Reference Pricing