More Than 300 Groups Seek Halt to CMS' Plans for Global Drug Pricing Index

A large coalition of medical associations, patient advocacy groups, drug companies, and others sent a letter to Congress Monday asking that they intervene on a CMS plan to use an index based on drug prices in other countries to determine reimbursement for Part B therapies, saying it would have a negative effect on the elderly and people with disabilities.

The Part B Access for Seniors and Physicians Coalition (ASP Coalition), along with 339 other groups, submitted a letter to congressional leaders urging them to block the implementation of the International Pricing Index (IPI) model announced by the Trump administration in October.

The letter urges Senate Majority Leader Mitch McConnell, R-Kansas, Senate Minority Leader Chuck Schumer, D-New York, House Speaker Paul Ryan, R-Wisconson, and House Minority Leader Nancy Pelosi, D-California, to come up with an alternate plan.

The proposed International Pricing Index would start in spring 2020 and be evaluated over the course of 5 years. CMS plans for the model to initially focus on single-source drugs and biologics. The potential model would test a payment for included drugs for when the average sales price is higher than an international price. In this instance, CMS would pay based on the target price based on the international price index.

CMS estimates that using an international price index instead of average sales price will reduce drug spending by approximately 30%. Comments are open on the proposal until December 31, 2018.

In the letter, the groups congratulate CMS for trying to strengthen competition and enhance value in Medicare Part B, but says the October proposal goes too far by making participation by Part B providers mandatory. Voluntary, small-scale reforms are fine, they said, but they believe the IPI proposal would create barriers between doctors and patients with cancer, autoimmune disorders and other complex, life-threatening conditions who rely on specialty drugs.

"The model would restrict access in the short-term, and reduce incentives for medical advancement in the long-term, ultimately posing serious risks to vulnerable Medicare beneficiaries,” the letter said. Future research and development would be harmed and control would be taken away from patients and doctors, they said.

On the day that President Trump announced the pricing index, HHS released a report comparing prices the United States paid for the top Medicare Part B drugs with the prices in other countries, including the United Kingdom, Canada, France, and Germany. The report found that prices in the United States were 1.8 times that of the average international price.

But in those countries, the letter said, access to medications are restricted by the government; in the United States, residents get access to innovative therapies 2 years earlier than patients in Europe, they said.

ASP is made up of 18 groups, including the Community Oncology Alliance, the American College of Rheumatology, Amerisource Bergen and others.