Reducing prescription drug costs, reducing administrative burden both key for CMS
NEW ORLEANS — The Centers for Medicare and Medicaid Services are actively looking for solutions to rising prescription drug costs and burdensome regulations, Seema Verma, MPH, administrator of the Centers for Medicare and Medicaid Services, said at the opening ceremony of the American Academy of Ophthalmology meeting.
“Through all of our works and efforts, CMS strives to help ensure that the American health care system remains the best in the world,” Verma said. “We know people travel from all over the globe to receive health care services here, because they understand that our doctors are amongst the finest in the world.”
CMS is actively engaged in several efforts to address concerns raised through meetings and discussions with providers across the nation: regulatory burdens, the rising costs of prescription drugs and different ways to pay for health care that “support value and quality over volume,” Verma said.
Spending on prescription drugs has been growing more quickly than spending in any other area of Medicare. Ophthalmologists rely heavily on Medicare Part B for physician administered drugs and are the second largest prescribers in Part B. The average ophthalmologist receives $469,000 per year in total payment for Part B drugs, she said.
“In therapeutic areas where competitors exist, either for multiple branded products or for branded products and generic products, market forces limit the amount by which prices can increase. Therefore, we’re identifying opportunities to increase competition in Medicare Part B and Part D, as well as in the Medicaid program, to help market forces lower drug costs,” Verma said.
Regulatory burdens have resulted in doctors spending more time complying with rules than caring for patients, according to Verma, who noted that CMS alone publishes more than 11,000 pages of regulations each year.
Earlier this year, CMS announced the “Patients over Paperwork” effort to review different organizations’ regulations and identify opportunities to reduce burden, Verma said.
“We’ve also recently announced our new complementary initiative, Meaningful Measures. This effort takes a new approach to quality measurement to reduce the burden of reporting on providers like yourselves,” she said.
Until a smaller set of impactful measures that assess outcomes, rather than processes, is identified, the burden of reporting measures will run the risk of outweighing their intended purpose, she said.
To promote biosimilars and increase competition, CMS recently announced a policy whereby biosimilars would get their own payment code to encourage manufacturers to invest in these drugs, Verma said.
“By lowering the cost of prescription drugs, it will help ensure that both you and your patients can access the therapies you need to deliver high-quality care,” she said. – by Robert Linnehan
Verma S. Keynote address from the Centers for Medicare and Medicaid Services Administrator. Presented at American Academy of Ophthalmology annual meeting; Nov. 11-14, 2017; New Orleans.
Disclosure: Verma reports no relevant financial disclosures.