Last week we talked about 3 reasons why Medicare Part D is a success. This week, we’re switching gears to talk about Medicare Part B. Here are 3 things to know about Medicare Part B:
- The Medicare Part B medical benefit covers an array of health care services. Part B covers physician office benefits, outpatient care, medical equipment and medications that are administered by a physician like vaccinations or chemotherapy. Read more about what Medicare Part B covers.
- Medicare pays a market-based rate for Part B medicines. Average Sales Price (ASP) is a market-based price that reflects the weighted average of all manufacturer sales prices and includes all rebates and discounts that are privately negotiated between manufacturers and purchasers (with the exception of Medicaid and certain federal discounts and rebates). This methodology mirrors reimbursement for physician-administered drugs in the commercial market. Learn more about ASP.
- Medicines are not a key driver of Medicare Part B costs. Spending on Part B medicines represents a small and stable share of overall Part B spending. Recent research found the volume-weighted average sales price for Part B drugs has remained steady year over year, suggesting that prescription medicines and biologicals are not a key driver of program costs. This is in part because Medicare Part B is influenced by competitive market forces such as generic entrants, alternative therapies and other market shifts. Learn more about the research.
Allyson Funk Ally is a former senior director of public affairs at PhRMA focused on advocacy issues for the biopharmaceutical industry. Her expertise includes Medicare, Medicaid, 340B, health reform and more. Prior to PhRMA, her experience includes leading health communications for a large membership organization, supporting public affairs clients and working for the governor of Louisiana.