Northwestern Medical Center warns against drastic medication pricing changes

Concerns over proposed outpatient medication pricing reforms took center stage during the Vermont Senate Health and Welfare meeting on May 29, 2025. Northwestern Medical Center (NMC) officials warned that drastic cuts to medication prices could jeopardize patient access to essential treatments and threaten the viability of their infusion center.

The discussion highlighted the stark contrast between the Average Sales Price (ASP) for medications and the actual costs faced by healthcare providers. NMC's representatives pointed out that while benchmarking against ASP might seem reasonable, aiming to reduce prices by 20 to 30% below the current lowest state costs could be "reckless." They emphasized that such a move would lead to immediate access issues for patients requiring critical therapies.

NMC provided specific examples of high-volume medications used in their infusion center, revealing significant discrepancies between ASP and their actual costs. For instance, the ASP for Flexra, a biosimilar medication, is $92.50 per unit, while NMC's cost is $450. Similarly, Remicade's ASP is $305.23, but NMC pays $875 per unit. These figures illustrate the financial strain on the facility, which has been operating at a negative margin for seven of the last eight years.

The representatives stressed that if the proposed pricing law were enacted as currently written, NMC would have no choice but to close its infusion center, further limiting patient access to necessary treatments. They also noted that other hospitals in Vermont, including UBMMC, lack the capacity to absorb the increased patient volume that would result from NMC's closure.

In conclusion, the meeting underscored the urgent need for a balanced approach to medication pricing that considers both the financial realities of healthcare providers and the critical need for patient access to treatment. NMC's officials expressed hope that Vermont hospitals could work together to advocate for a pricing strategy that aligns more closely with national averages, ensuring that essential services remain available to the community.