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SEPTEMBER 5, 2024

Markups, biosimilars offer some relief

Offsetting High Drug Costs Is a Moving Target

By Marcus A. Banks

One of Medicare’s primary reimbursement policies adds costs to a health system that is already spending at rates dwarfing other countries, payment experts noted during a finance session at the HOPA Annual Conference 2024, in Tampa, Fla.

Health systems typically purchase pharmaceuticals at one price, and then bill for those costs plus a percentage markup. For example, reimbursement by Medicare for outpatient drugs is based on the average sales price of the medications plus