Employers and benefits advisors now have a chance to shape a federal drug cost benchmark data program that affects what health plan participants pay for prescription drugs.
The Centers for Medicare & Medicaid Services is asking the public for comments on the National Average Drug Acquisition Cost survey program.
Members of the public can tell CMS about “ways to enhance the quality, utility and clarity of the information to be collected,” according to a notice that CMS published in the Federal Register.
The Federal Register is an official federal government rulemaking publication.
Responses are due Nov. 2.
See also: Specialty drug costs expected to jump 32% by 2028, PSG finds
CMS polls 72,000 pharmacies about drug costs monthly
CMS polls about 72,000 pharmacies every month through the NADAC program to ask them what prescription drugs really cost.
States use the NADAC survey results to determine what participants in Medicaid and other state health programs are paying to fill prescriptions.
Many employer-sponsored health plans also use NADAC data, either directly or indirectly, to set the reimbursement rates for covered drugs.
Employer plans can also get average wholesale price from Red Book and other commercial sources.
Some drug procurement specialists recommend use of NADAC data because CMS makes the NADAC data available free of charge and posts extensive information about how it runs the NADAC program.
Information collection reviews: The federal Paperwork Review Act of 1995 requires CMS and many other agencies to put efforts to collect information from the public through regular paperwork burden review processes.
Few members of the public submit comments, and that means that any comments that are submitted may have a real chance to get program managers’ attention.
What it means: Benefits professionals who think that the NADAC program produces cost figures that are too high or too low, or who want the program to ask for more information from pharmacies, may be able to influence how the program works.
