Neb-med pricing stays stable, but market changes loom

BALTIMORE - Nebulizer medication payments will stay about the same for the fourth quarter, but industry stakeholders say there is an “uneasy” feeling in the market as drug manufacturers shift gears.

In October, Dey Laboratories will cease producing generic DuoNeb, along with albuterol and ipratroprium. Those drugs will be manufactured by Dey's parent company, Mylan Pharmaceuticals, one of the largest generics manufacturers in the world. The word on the street is that Mylan wants to increase prices for all three drugs, said Chuck Makarov, president and CEO of Letco Companies.

"With the average sales prices coming down and Mylan wanting to increase prices—it's created an uneasy world for the people filling the scripts," he said. "Providers are concerned about how to make money. They're only making pennies a dose."

The ASP for generic DuoNeb (J7620) was down 3 cents to 22 cents per dose for the fourth quarter. Albuterol (J7613) was down 1 cent to 12 cents per dose; ipratroprium (J7644) was 10 cents per dose.

Also ahead in the generic space: The official launch of generic Pulmicort in December. Its average sales price was down 2 cents to $6.07 per dose for the fourth quarter.

"I don't see how that allowable could go down when all we've seen is price increases over the last 18 months," said provider Dave McDonald, president/owner of Senior Respiratory Solutions in Texarkana, Texas.

Levalbuterol (J7614) was down 8 cents to 53 cents per dose for the fourth quarter.

Pricing remains high for brand-name drugs Brovana (J7605), which dropped 7 cents to $5.01 per dose and Perforomist (J7606), which rose 11 cents to $4.49 per dose. Many providers continue to dispense those drugs, both long-acting bronchodilators (LABA), but they say Medicare's requirement that patients must first try a short-acting drug is creating a push-back from physicians.

"The physicians want to prescribe the LABA drugs initially, when the patient is first diagnosed, and they get upset with us because they can't," said Sam Jarczynski, president of RxStat in St. Petersburg, Fla. "Medicare needs to stop meddling and telling physicians how to prescribe drugs."