CMS expects more pass-through applications

Executive Summary

With the payment rate for Medicare Part B drugs cut to average sales price plus 5 percent in the 2008 hospital outpatient payment system, "we expect a kind of increase in the number of pass-through applications for drugs and biologicals," CMS Acting Deputy Director-Hospital and Ambulatory Group Don Thompson said at the Nov. 13 Medical Device Manufacturers Association annual meeting (1"The Pink Sheet" Nov. 5, 2007, p. 32). Pass-through drugs, drugs with little Medicare pricing history that can be used to set payments, are paid at the same rate as drugs administered in the physician's office: ASP plus 6 percent. In the final rule, CMS extends the pass-through status of one of the seven originally proposed to expire - Biogen Idec/Elan's Tysabri (natalizumab) - and added three drugs to the proposed list of 13 drugs set to maintain pass through status in the coming year - Alexion's Soliris (exulizumab), Novartis' Reclast (zoledronic acid) and Wyeth's Torisel (temsirolimus)...