Navigation Links
Plasma Protein Therapeutics Association Urges CMS For Appropriate Hospital Outpatient Drug Reimbursement
Date:8/11/2009

ANNAPOLIS, Md., Aug. 11 /PRNewswire/ -- The Plasma Protein Therapeutics Association (PPTA) supports the favorable recommendation of average sales price (ASP) + 6 percent for reimbursement of separately paid drugs and biologics in the hospital outpatient setting made by the Centers for Medicare and Medicaid Services' (CMS) Advisory Panel on Ambulatory Payment Classification (APC) at its August 5-7 meeting, although third party data maintains that ASP +12 percent is the appropriate reimbursement level.

PPTA presented the APC Panel with compelling evidence demonstrating that setting the current ASP + 4 percent payment rate was based to some extent on flawed hospital claims data and is insufficient to assure patient access to lifesaving plasma protein therapies.

PPTA's comments as part of the stakeholder panel focused largely on evidence that sales into the 340B Drug Discount Pricing Program are skewing CMS's rate setting calculation in the Outpatient Prospective Payment System (OPPS). Further, health care reform legislation if enacted will exacerbate the disparity, given that proposals to expand 340B and to increase the Medicaid outpatient drug rebate percentage will result in a larger volume of products being sold at significantly deeper discounts to 340B hospitals.

In its testimony, PPTA referenced data compiled by The Moran Company, a Washington, D.C.-based health care research and consulting firm, which revealed that removing 340B sales from the rate setting and reallocating the $150 million CMS has proposed to move from packaged drugs to separately payable drugs to cover pharmacy overhead costs results in the more appropriate ASP +12 percent reimbursement level.

The 340B program limits the cost of covered outpatient drugs to certain federal grantees, federally-qualified health centers, qualified disproportionate share hospitals and hemophilia treatment centers. The program currently provides access to 340B sub-ceiling prices for more than 2,800 drug products including biologics.

Maintaining an appropriate reimbursement level is an important step in assuring access to plasma protein therapies, which are highly complex biologics, for Medicare beneficiaries suffering from rare, chronic and genetic diseases and disorders including primary immunodeficiency diseases, hemophilia and other bleeding disorders and alpha-1 antitrypsin deficiency, a genetic lung disease. Plasma protein therapies refer to plasma-derived and recombinant blood clotting factors, as well as alpha-1 proteinase inhibitor and immune globulins.

Additionally, the CMS' proposal to continue to insufficiently reimburse plasma protein therapies could make innovative advances, such as a recently approved biologics license application for a coagulation therapy used to treat a disorder afflicting only 300 people in the United States, cost prohibitive in the future.

The APC Panel's recommendation is an important step on the way to preserving patient access to lifesaving therapies, and PPTA urges CMS in 2010 to at a minimum restore the payment level to ASP +6 percent, which is consistent with reimbursement of these drugs in the physician office setting.

Go online for a copy of PPTA's written testimony, or contact Kym Kilbourne at 443-995-2102 or email her at kkilbourne@pptaglobal.org. More information about the Plasma Protein Therapeutics Association (PPTA) can be found at www.pptaglobal.org.

The Plasma Protein Therapeutics Association (PPTA) is the trade association and standard setting organization for the world's major producers of plasmaderived and recombinant analog therapies (collectively, "plasma protein therapies"). These therapies are used by more than 1 million worldwide each year to treat a variety of diseases and serious medical conditions. PPTA members produce over 80 percent of the plasma therapies for the United States market and more than 60 percent worldwide. Some of the critical therapies produced by PPTA members include: blood clotting factors for people with hemophilia, immune globulins used to prevent infections in people with immune deficiencies and other serious conditions, and alpha1 proteinase inhibitor used to treat people with alpha1antitrypsin deficiency, also known as genetic emphysema.


'/>"/>
SOURCE Plasma Protein Therapeutics Association
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. PEAK Surgical Introduces PEAK PlasmaBlade(TM) TnA
2. Platelet Rich Plasma Therapy (PRP) Accelerates Healing of Joint Injuries, Osteoarthritis Pain
3. PEAK Surgical Announces First Use of PEAK PlasmaBlade(TM) in Europe
4. PEAK Surgical Announces Positive Fascia Incision Healing Results From Preclinical Study of PEAK PlasmaBlade(TM) for Gynecologic Surgery
5. Research Shows Plasma Exchange Helps Multiple Sclerosis Patients
6. CIDP Treated With Plasma-Derived Therapy
7. Biotest Pharmaceuticals Corporation Acquires Santa Fe, New Mexico Plasmapheresis Center
8. Grifols Inaugurates the GRIFOLS ACADEMY OF PLASMAPHERESIS in Glendale, Arizona
9. Kawasaki Disease Treated with Plasma-Derived Therapy
10. PPTA Launches New Educational Website on Donating Plasma
11. Grifols Biomat USA Opens New Plasma Donor Center in Lincoln
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a ... can give their videos a whole new perspective by using the title layers ... Film Studios. , ProSlice Levels contains over 30 Different presets to choose from. ...
(Date:6/25/2016)... ... 25, 2016 , ... Experts from the American Institutes for ... Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR ... care planning, healthcare costs and patient and family engagement. , AIR researchers will ...
(Date:6/25/2016)... ... 2016 , ... First Choice Emergency Room , the largest network of ... Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased to ... said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/25/2016)... ... 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether it’s ... setting the bar too high can result in disappointment, perhaps even self-loathing. However, those ... goal. , Research from PsychTests.com reveals that behind the tendency to ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was out ... family verbally and physically. , “When something upset him, he couldn’t control his emotions,” remembers ... would throw rocks at my other children and say he was going to kill them. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Revolutionary technology ... Oticon , industry leaders in advanced audiology and ... Oticon Opn ™, the world,s first internet connected ... for IoT devices.      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ... a number of ,world firsts,: , TwinLink™ ...
(Date:6/23/2016)... , June 23, 2016 Research ... "Surgical Procedure Volumes: Global Analysis (United States, China, Japan, ... report to their offering. ... tool for healthcare business planners, provides surgical procedure volume ... surgery trends with an in-depth analysis of growth drivers ...
(Date:6/23/2016)... -- The National Pharmaceutical Council (NPC) today announced that ... organization as its newest member.  ... and chief scientific officer, Mallinckrodt Pharmaceuticals, will serve ... of Directors. ... in support of our efforts to conduct research ...
Breaking Medicine Technology: