2006 proposed fee schedule - American Society of Clinical Oncology

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independent facilities, to account for spending on syringes
that were included in the EPO payments prior to the
implementation of the MMA drug payment provisions. In
CY 2005, we estimate payments for these syringes will amount
to $1.6 million for hospital-based facilities and $26.8
million for independent facilities. For CY 2005, we
estimate that total spending, after the deduction of
payments for syringes, will reach $246 million for Epogen
provided in hospital-based facilities, and $2.850 million
for drugs provided in independent facilities ($1.960 million
for Epogen and $890 million for other drugs). We note that
all other drugs provided in hospital-based ESRD facilities
continue to be paid at cost.
(6) Add-On Calculation and Budget Neutrality
For each of the top 10 drugs (as explained below), we
calculated the percent by which ASP +6 percent is projected
to be less than payment amounts under the 95 percent of AWP
pricing system for CY 2005. For Epogen, this amount is 7.5
percent. We applied this 7.5 percent figure to the total
aggregate drug payments for Epogen in hospital-based
facilities, resulting in a difference of $18 million.
We then calculated a weighted average of the
percentages by which ASP +6 percent would be below 95
percent of AWP payment prices, for the top 10 ESRD drugs for
independent facilities. We weighted these percentages by