Specifically, the report recommends lowering Medicare reimbursements for drugs that have an average sales price that exceeds the price paid by wholesalers by more than 5 percent. OIG also recommends expanding that policy, even if only partial pricing data are available, and says CMS should seek legislative changes requiring drugmakers who participate in Part B to submit data on average and wholesale prices.
CMS in July 2010 proposed cutting its reimbursements when average prices exceed wholesale prices by more than 5 percent for several quarters, but the regulation was shelved following an injunction prohibiting the disclosure of wholesale prices to the public.
In his response to Levinson, Berwick wrote that the president's budget proposal for 2012 does not require drugmakers to share their pricing data.
"However," Berwick wrote, "we will continue to monitor manufacturer reporting trends and their effect on our current payment policies."