Hospital groups and healthcare think tanks are urging CMS to revise its proposal to address medication shortages, which have been persistent for decades and have struck multiple therapeutic areas in 2023.
In the U.S., numerous chemotherapies, local anesthetics and attention-deficit/hyperactivity disorder drugs have been in short supply for months, and in the first quarter of the year, the number of drug shortages hit a 10-year high.
In July, CMS proposed reimbursing hospitals for creating a three-month stockpile of essential medicines. This idea is taking heat from the American Hospital Association, America's Essential Hospitals and Brookings Institution. The organizations said the proposal could worsen health inequities.
"A policy that does not include the costs of the essential medicines themselves could create inequities in access, especially for small independent hospitals which are unable to pay the high up-front cost of the essential medicines themselves to establish a buffer stock," the AHA said in a letter to CMS dated Sept. 8.
The Schaeffer Initiative on Health Policy Department of Industrial Engineering, part of the Brookings Institution, agreed. The think tank told CMS its proposal could help well-resourced hospitals "that least need it" while ignoring ones that need it most, such as rural medical centers.
America's Essential Hospitals said the idea is "incremental" toward mitigating drug shortages, but argues the reimbursement only supports hospitals that can afford a three-month stockpile. Otherwise, it will be "a significant expense for hospitals with limited cash on hand," the organization said in a Sept. 11 letter.
Both the AHA and America's Essential Hospitals claim an upfront payment model for creating a stockpile of critical drugs would be more efficient.