Pharmacy Question for the Week of December 3, 2018

Question:

Can you tell me anything about the add-on payment for drugs used for ESRD patients?

Answer:

We believe that you are talking about the end-stage renal disease (ESRD) prospective payment system (PPS) transitional drug add-on payment adjustment (TDAPA).

The intent of the TDAPA, a federal law, is to facilitate beneficiary access to certain qualifying, new injectable or intravenous products by allowing payment for these drugs and biologicals while the necessary utilization data is collected. According to the Centers for Medicare & Medicaid Services (CMS), this data will be used to incorporate the costs of these qualifying drugs into the ESRD PPS. For more on this policy, go to https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/ESRD-Transitional-Drug.html.