decisionhealth Newsletters, Part B News - 2017 Issue 6 (June)
3Q 2017 ASP drug price limits continue upward trend — mostly for high-end drugs
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Article Overview
This article reviews CMS average sales price (ASP) drug price limit revisions for Q3 2017 and compares them with prior quarters and prior years. It is aimed at readers who track drug reimbursement trends, especially those interested in Medicare pricing updates, frequently billed drug products, and the relative movement of lower-cost versus high-cost therapies.
Why This Topic Matters
ASP updates can affect reimbursement, budgeting, and utilization patterns across provider settings. The article highlights how small percentage changes may matter for high-cost drugs and for widely used drugs with large claim volumes.
Article Sections
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ASP price trend overview
Summarizes the overall direction of CMS ASP drug price revisions across multiple time periods. It frames the article’s comparison of short-term and longer-term pricing movement.
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Large quarterly and annual price changes
Reviews the most notable increases and decreases in drug pricing over the quarter and over the prior year. This section emphasizes how changes vary across different drug categories and price points.
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Small shifts, but big prices
Discusses the impact of relatively small price changes on expensive therapies and on heavily utilized drugs. It also introduces a table of commonly billed drugs and their ASP movements.
What You Will Learn
- How CMS ASP drug price limits changed over Q3 2017 compared with earlier periods
- Which kinds of drugs experienced the largest overall pricing movements
- Why modest percentage changes can still matter for high-cost or high-volume drugs
- How frequently billed drugs are presented in the article’s pricing table
Who Should Read This
- Medical coders
- Billing professionals
- Revenue cycle staff
- Pharmacy reimbursement analysts
- Healthcare administrators
- Payer policy readers
Codes Discussed
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