A newly proposed drug reimbursement plan from The Centers for Medicare & Medicaid (CMS) has oncology associations up in arms, whereas a well-known patient advocate and oncologist says he sees method in the payment scheme. The proposal to change Medicare Part B payment comes with a number of strategies to experiment with pricing, coinsurance elimination, and risk sharing that would be meted out in geographical samplings to see how well they perform.

The most prominent proposed changes to Medicare Part B drug reimbursement would reduce the add-on physician payment from 6% per drug to 2.5%, although a $16.80 per drug, per day payment would be added to the total.1 The plan is designed to make it less enticing for physicians to earn the highest possible payments simply by prescribing the most expensive drugs. The reduced percentage coupled with the daily fee will in many cases improve payments for lower priced drugs while lowering payments for higher priced ones (Table).