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Comparison of Average Sales Prices and Average Manufacturer Prices

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive Medicare payment amounts. The Social Security Act mandates that the OIG compare ASPs with average manufacturer prices (AMPs). If OIG finds that the ASP for a drug exceeds the AMP by 5 percent in the two previous quarters or three of the previous four quarters, the Secretary of Health and Human Services may substitute the reimbursement amount with a lower calculated rate. These quarterly memos summarize the results of OIG's comparison analysis based on ASP and AMP data. The memo specifically reports the number of drugs OIG identified that met the criteria for substitution of a lower reimbursement amount.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
October 2020 Centers for Medicare and Medicaid Services Comparison of Average Sales Prices and Average Manufacturer Prices Office of Evaluation and Inspections OEI-03-21-00050;
OEI-03-21-00060;
OEI-03-21-00070;
OEI-03-21-00080
2021