Considering Solutions for Oncology Drug Purchasing

Thank you for your comments on the recent ASP post. Oncologists need to band together and find a solution to this problem.

Yes, this is doable. We need to create and engage in a process that suggests finding a solution in a free market system.

Medicare will never hear our plea for better reimbursement unless we can prove with documentation and examples that:
1. ASP is not working and why.
2. The current coding system is not properly reimbursing you for your cost.

How do we prove this to Medicare?

Who can purchase drugs at ASP or lower? You know that many of you are unfairly purchasing at ASP or higher. Following are some points to investigate in proving our case to Medicare:

1. How can we determine that the ASP formula is flawed?
2. Are distributors, GPO (Government Printing Office) and manufacturers taking more profit from the ASP formula than what they should be taking? Would the government agree?
3. Is it true that distributors obtain 2% plus from the manufacturers that are not counted in the ASP formula? If this is true, do distributors need to take another 4% profit from their customers?
4. Why hasn’t One Oncology launched its product? We are told that distributors will not sell to them and this interferes with the free market system. So, who is responsible for stopping this from working?
5. Have the manufacturers, distributors and GPOs misled their customers by making them think they are purchasing drugs below ASP, when in fact the customer is buying below ASP + 6% (huge difference)?
6. Isn’t the GPO supposed to help practices save money?
7. Aren’t we all supposed to purchase drugs at ASP?

Share your thoughts and ideas so we can collectively find the solution. On our Neltner Billing website, we have posted a short “worksheet” in the News area that will enable you to compare the Medicare allowable to what you are actually paying. You can fill it out, fax it back to us anonymously and we will build a spreadsheet with the results we receive. I think this is the type of real data we need to start lobbying.

Our next post will include a sample letter and instructions on writing your senators and congress representatives about this issue. We will do the same. If enough oncologists/ hematologists write in, we can create momentum. I think this is the first step in developing awareness.