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Orals in the bundle: a policy framework.

Rachel L Feldman¹, Mark P Desmarais, James S Muller

¹The Moran Company, Arlington, Virginia 22209, USA. rlfeldman@themorancompany.com

Clinical Journal of the American Society of Nephrology : CJASN

|April 20, 2013

Summary

This summary is machine-generated.

Medicare Part B will integrate oral dialysis drugs in 2016, shifting from Part D. This policy change requires a robust framework for valuation, considering drug utilization, costs, and patient adherence to ensure adequate funding for End-Stage Renal Disease (ESRD) care.

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Area of Science:

Health Policy
Nephrology
Pharmaceutical Economics

Background:

Oral prescription drugs for bone and mineral disorders in dialysis patients (ESRD) are shifting from Medicare Part D to Part B in 2016.
This integration into the Medicare Part B ESRD bundled payment system lacks policy precedent.
Significant concerns exist regarding potential funding inadequacy and lack of clear guidance from CMS.

Purpose of the Study:

To propose a policy framework for valuing oral drugs integrated into the Medicare Part B ESRD bundled payment system.
To address concerns about adequate funding and policy transparency for End-Stage Renal Disease (ESRD) treatments.

Main Methods:

Utilizing recent Medicare Part D data for valuation.
Measuring mean drug utilization over at least six months of complete prescription and dialysis data.
Employing price proxies for drug volume, adjusting for adherence changes due to out-of-pocket expenses, and including dispensing/administrative costs.

Main Results:

The proposed framework emphasizes data-driven valuation and cost-conscious adjustments.
It aims to establish a mechanism for future payment adjustments based on adherence changes.
The approach seeks to ensure fair compensation for providers and appropriate access for patients.

Conclusions:

An adequate policy framework is crucial for the successful valuation of oral drugs in the ESRD bundled payment system.
The proposed methods provide a transparent and data-informed approach to payment policy.
This framework is essential for managing costs and maintaining adherence in ESRD patient care.