2006 proposed fee schedule - American Society of Clinical Oncology

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using the CY 2005 estimated Medicare payment amounts for the
top 10 drugs. This procedure resulted in a weighted average
payment reduction of 12 percent. We note that in the
previous calculation for the CY 2005 add-on adjustment, we
had used CY 2002 values from the OIG. (See Table 22 for the
calculated drug weights, and Table 23 for the percentage by
which ASP prices are lower than AWP prices.) The CY 2003
data projected forward to CY 2005 indicated a significant
drop in payments for drugs other than Epogen that are
provided in an independent facility. This trend, which we
expect will continue when we obtain CY 2004 historical data
for the final rule, decreases the weights of the drugs,
other than Epogen and increases the weight of Epogen. The
overall effect is to lower the weighted average by several
percentage points.
Drugs
TABLE 22
CY 2005 Estimated Drug
Payments As a Percentage of
Total Drug Expenditures
(percent)
CY 2002 OIG Drug
Payments As a Percentage
of Total Drug
Expenditures
(percent)
Epogen 78.83 67.85
Calcitriol 0.13 1.22
Doxercalciferol 1.74 1.28
Iron_dextran 0.38 0.65
Iron_sucrose 0.71 5.00
Levocarnitine 0.89 1.68
Paricalcitol 17.37 15.90
Sodium_ferric_glut 0.53 6.03
Alteplase, Recombinant 0.18 0.19
Vancomycin 0.24 0.20
*Compared to the $10.00 statutory price.