Witnesses urge cap on hospital outpatient drug prices as debate over white bagging continues

Summary

Charles Becker, staff attorney with the Office of the Health Care Advocate, told legislators May 13 that Vermont’s hospital outpatient‑administered drug prices are far above the national benchmark and urged either a temporary repeal of the white‑bagging ban or—preferably—a statutory reimbursement cap tied to average sales price to reduce patient costs.

Charles Becker, staff attorney with the Office of the Health Care Advocate, and Jennifer Cohen, general counsel for the Office of Professional Regulation, testified May 13 about competing paths to lower Vermonters’ costs for physician‑administered outpatient drugs as legislators consider changes to H.266.

Becker said that if H.266’s Senate amendment allowing white bagging becomes law and the bill’s reporting requirements are implemented, the state will better see how much outpatient‑administered drugs contribute to hospital revenue. "If H.266 becomes law and we get the reporting that the bill calls for...the largest source of $3.40 b revenue for Vermont hospitals is far and away these outpatient administered drugs," he said. Becker and other witnesses pointed to a chart showing Vermont’s hospital‑administered drug prices at about 600% of average sales price (ASP) on average and, in some instances, as much as 2,000% of ASP.

Becker and others pressed two policy options: repeal the 2022 prohibition on insurer‑mandated white bagging so health plans could require drugs be shipped from a preferred specialty pharmacy, or set a statutory reimbursement cap linked to ASP (for example, ASP plus 20% or a fixed percentage such…

Witnesses urge cap on hospital outpatient drug prices as debate over white bagging continues

Summary

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