Site-of-Care Shift for Physician-Administered Drug Therapies: 2022 Update

In 2019, the author published a white paper evaluating the breakdown in site of care for all Medicare Part B drug therapies, as well as the top drugs used to treat several conditions (breast cancer, rheumatoid arthritis, and multiple myeloma). The paper observed a trend of care shifting from physician offices and other non-340B facilities toward the 340B hospital outpatient department (HOPD) setting from 2008 to 2017. This trend was observed for physician-administered Part B drug therapies overall and for each of the three conditions assessed.

This current paper updates the prior analyses to reflect Medicare claims data through 2021. It also compares the size of the 340B Drug Discount Program to the total size of Part B drug sales as measured by wholesaler acquisition cost (WAC). In 2021, more than 35 percent of total Part B outpatient drug administrations, as weighted by the average sales price (ASP) of the drug, occurred in the 340B HOPD setting, up more than 16 percentage points from 2012.

This study was funded by the Pharmaceutical Research and Manufacturers of America.