REIMBURSEMENT CUTS FOR COMPOUNDED RXs DRAW OBJECTIONS

Pharmacy Times, Volume 0, 0

Pharmacy leaders are urging Medicare officialsto hammer out a 2-tiered reimbursementsystem that would provide extra compensationto pharmacists who dispense certain compoundedmedicines.

"Because of the time and effort required toprepare a compounded medication and theadditional service costs incurred, the dispensingfee for a compounded medication shouldbe higher than the dispensing fee for a noncompoundedform," argued top officials fromthe American Pharmacists Association (APhA)and the International Academy of CompoundingPharmacists (IACP).

The joint appeal was prompted by recentstatements by the former administrator of theCenters for Medicare & Medicaid Services(CMS), Mark McClellan, MD, PhD. He had indicatedthat CMS would create new billing codesto distinguish between compounded and noncompoundedinhalation medications.

These new billing codes will allow CMS tocontinue reimbursing noncompounded formsof the drugs at 106% of the average sales price.APhA and IACP, however, raised concerns thatthe agency would be establishing "a separate—and likely lower—reimbursement rate for compoundedpreparations."

According to the officials of the 2 pharmacygroups, "compounding requires extra time andeffort, special equipment, safety precautions,and testing—all of which add costs to the medication."They warned, "Pharmacies may beforced to discontinue providing compoundingservices and these important medications totheir patients."