Comparison of Average Sales Prices to Average Manufacturer Prices - Mandatory Review

In 2005, Medicare began paying for most Part B drugs using a new methodology based on the average sales prices (ASP). The enabling law required that OIG compare ASPs with average manufacturer prices (AMP) (Social Security Act § 1847A(d)(2)(B). Pursuant to the requirement, OIG conducts such reviews and issues quarterly and annual reports of its findings. When OIG finds that the ASP for a drug exceeds the AMP by a certain threshold (5 percent), OIG notifies the HHS Secretary, who may disregard the ASP for the drug when setting reimbursement amounts, e.g., apply a price substitution policy. We will review Medicare Part B drug prices by comparing ASPs to AMPs and identify drug prices that exceed a designated threshold.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
Nov-16	Centers for Medicare & Medicaid Services	Comparison of Average Sales Prices to Average Manufacturer Prices � Mandatory Review	Office of Evaluation and Inspections	OEI-03-16-00540, OEI-03-17-00360; OEI-00-00-0000	2017