New Year brings few changes to neb-med pricing

Tuesday, December 22, 2009

BALTIMORE – Neb-med reimbursement for the first quarter of 2010 showed little variance from last quarter, but a few industry changes in December, including the launch of a generic, promise to keep things interesting in the New Year.

The latest average sales price (ASP) figures include slight decreases for levalbuterol (J7614), down 4 cents to 49 cents per dose; and generic DuoNeb (J7620), down 2 cents to 23 cents per dose.

Ipratroprium (J7644) came in at 10.5 cents per dose. Albuterol (J7613), at roughly 12.5 cents per dose, continues to be a money loser for providers. In October, drug manufacturers raised the cost of the drug to bring it more in line with retail drug pricing.

"We're paying 3 or 4 cents a dose more then we get paid for it," said provider Dave MacDonald, president/owner of Senior Respiratory Solutions in Texarkana, Texas.

One drug that saw a significant increase: Pulmicort (J7626), which rose 36 cents to $6.43. That figure will come down over the next several quarters thanks to the Dec. 15 launch of a generic by drug maker Teva, say industry sources.

Reimbursement continues to stay high for long-acting bronchodilators (LABA) like Brovana (J7605) at $5.02 per dose and Perforomist (J7606) at $4.52 per dose. Starting Dec. 1, Medicare stopped requiring that patients first try a short-acting drug. That could open up the market for the two drugs, say sources.

"I think we might see a significant increase in LABA usage," said Wayne Vega, vice president of sales for Harvard Drug Group. "These drugs are under 2% of the market share, but with the criteria lifted, the opportunity is huge."