Wide disparities found in hospitals' drug prices
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Prices of common drugs for cancer, multiple sclerosis and other conditions can vary widely depending on the hospital where they're administered, research firm 3 Axis Advisors said in a new report.
Why it matters: Hospital pricing remains opaque, and it's possible for the same drug at the same hospital to have a dozen different prices on the same day, according to the findings prepared for the nonprofit Patient Rights Advocate and provided first to Axios.
- That's despite federal rules requiring hospitals to provide comprehensive files with all of their offered items and services, as well as consumer-friendly lists of services that would let patients compare prices.
What they found: A 200-milligram dose of the cancer drug Keytruda ranged from $12,000 to $43,000, the research firm found through files published under the transparency rules.
- The immunotherapy Opdivo ranged from $17,000 to $67,000, while the MS drug Ocrevus was priced from $16,000 to $65,000.
- One insurer might pay $1 while another pays $2,347 for the same service at the same facility, according to the analysis of more than 1,300 hospital files.
Between the lines: Different billing methods, opaque contracts and data quality problems combine to create the significant price variances.
- 3 Axis found while there is often consistency in list prices shown to insurers and patients, insured patients can still face a confusing array of potential prices.
- The cash discount for uninsured patients in half of the cases examined was only 30% or less off the full list price.
- In contrast, most negotiated rates by insurers appeared to average around 40% off the full list price, though there are wide ranges of negotiated rates.
The analysis found many hospitals are not providing usable data or complying with the spirit of transparency rules when they do post prices.
- It recommended more federal oversight into drug pricing and that hospitals align with pharmacy billing standards, among other steps.
