ASP: DuoNeb takes big hit

BALTIMORE--The average sales price (ASP) figures for respiratory medications released in September contained few surprises, with one exception. The biggest drop: a 48% decrease in DuoNeb (J7620) from 58 cents to 31 cents per dose. “It got killed,” said Sam Jarczynski, president of St. Petersburg, Fla.-based Rx Stat. “I don't know how many pharmacies are going to stay in business.” At the other end of the spectrum, the market's two newest two drugs received the biggest price boost. Sepracor's Brovana (J7605) and Dey's Perforomist (Q4099) both rose about 20 cents, to $4.99 and $4.29 respectively. Higher reimbursement for the drugs, both long-acting beta agonists, means more providers will add them to their product mix, industry sources say. “That will allow us to go with Brovana more,” said Mike Boyce, director of sales and marketing for Cincinnati, Ohio-based HME Services. “We haven't aggressively marketed it in the past. We do a lot of generic DuoNeb and albuterol and ipratropium. Those drugs are the backbone of our business.” Other providers rely on the $33 monthly dispensing fee to stay profitable, regardless of ASP figures. “It's a dispensing fee world and we are able to handle that,” said David McDonald, president of Senior Respiratory Solutions in Texarkana, Texas. “We provide all the commercially available drugs. If we can break even on the drugs, we are glad to provide them.” But with more expensive brand-name drugs offering the only real possibility of profit, that could drive up overall reimbursement, something that Medicare doesn't like, said Mickey Letson, president of Decatur, Ala.-based Letco Companies. “CMS created this mess so they shouldn't blame providers in six to nine months when you see how reimbursement has spiked,” he said.