Thirteen Years of ASP Checks Bought Medicare $78 Million
OIG's annual price-substitution brief landed Thursday: $1.6 million saved on 2024 sales data, against $61 billion of Part B drug spending, and 31 drug codes it could not evaluate at all because the manufacturer-reported AMP data looked wrong. Everything else that published this week counts things rather than pays for them, and the October outpatient and ASC rate files are still missing with four days to go.
Thirteen years of a statutory price check on Medicare Part B drugs have produced $78 million in savings.
That is the cumulative number, 2013 to now, in the data brief HHS-OIG posted Thursday. The single-year figure is $1.6 million, against the $61 billion Medicare and its enrollees spent on these drugs in 2024.
"How much does the only mandatory price check on Part B drugs actually take off the bill?"
Less than three thousandths of one percent.
Thirty-One Codes Nobody Could Check
Section 1847A(d) is the mechanism: every quarter OIG compares each drug's ASP against its AMP, and a gap over 5% puts the drug in front of CMS for a cut to 103% of AMP. We walked the arithmetic on August 15.
OEI-03-26-00080 closes the loop on 2024. CMS substituted prices for 14 drugs off that year's data, spread across Q4 2024 through Q3 2025, and has now done 101 drugs since 2013.
Here is the part that should bother anyone who bills buy-and-bill. OIG could not evaluate 31 drug codes at all, because the AMP data manufacturers reported carried a likely error in either the unit type or the amount itself.
Seven of those 31 cleared the 5% threshold in at least one quarter anyway, and OIG refused to refer them on data it does not trust.
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