Medicare Part B Drugs With Discarded Units Above the 10% Threshold

With the release of the Medicare Part B discarded units’ policy, the life sciences industry is seeking to better understand the shifting landscape and evaluate key impacts. The ADVI Strategic Analytics, Value and Economics (SAVEs) team has been analyzing Medicare claims data to assess specific drug-dosing patterns in both the outpatient hospital and physician office setting. This data, along with a 3-step plan has allowed ADVI’s clients to assess their approach for future CMS engagement and go-to-market strategies.

ADVI SAVEs 3-Step Discarded Units’ Quarterly Support Plan

ADVI continually works with clients using a 3-step plan to better understand the implications of the Medicare Part B discarded units’ policy. These steps include:

1. Calculating discarded units’ percentages by products and by site of service (i.e., HOPD, office, etc.)
2. Analyzing outpatient hospital and physician office billing practices for administered vs discarded units
3. Estimating product-level liability based on CMS’ established 10 percent threshold

For a list of the Part B drugs with discarded units’ percentage over the 10 percent threshold, see our table here
(ADVI Health Analysis of 2021 vs 2022 Data Related to Part B Drug Discarded Units).

The SAVEs team will continue to provide clients with a first look at how the changes may impact their business. If you are interested in additional analysis related to Part B drug discarded units, or the Part B or Part D drug dashboards please get in touch.

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Caitlin Sheetz, MPH
Senior Vice President and Head of Strategic Analytics, Value and Economics