MSP Compliance Blog


Expert summary, analysis and recommendations on issues impacting Medicare Secondary Payer compliance.

Celebrex and Abilify Price Drops Trigger MSA Reductions

Posted on December 14, 2020 by Daniel Anders

Recently, the lowest average wholesale price of Celebrex 200mg and the price of multiple strengths of Abilify dropped dramatically resulting in major cost savings to Medicare Set-Aside allocations. 
 
A widely used, non-steroidal anti-inflammatory drug, Celebrex (Celecoxib), is FDA-approved for several conditions:

  • Ankylosing spondylitis
  • Juvenile rheumatoid arthritis
  • Acute migraines
  • Osteoarthritis
  • Acute pain
  • Primary dysmenorrhea
  • Rheumatoid arthritis

Per Red Book, the lowest average wholesale price for Celecoxib 200mg dropped from $1.79 to $0.33, an 81.56% price reduction.
 
Abilify (Aripiprazole) is an antipsychotic drug FDA-approved for the following conditions: 

  • Schizophrenia
  • Acute treatment of manic and mixed episodes associated with bipolar
  • Adjunctive treatment of major depressive disorder
  • Irritability associated with autistic disorder
  • Treatment of Tourette’s disorder

Per Red Book, the lowest average wholesale price for multiple strengths (2mg to 30mg) of Aripiprazole dropped from the $30 to $36 range to a range of $0.07 to $0.17 per dose, an almost 100% price reduction.
 
Tower Action in Response
 
Because Tower’s system tracks all medications allocated in MSA reports, we have already pulled reports from the past two years that allocated these medications and advised clients of the potential for a reduction. You can also contact us to determine whether a particular MSA qualifies for a reduction.  Revisions to the MSA can be done now or prior to MSA submission to CMS.
 
Please contact Dan Anders, Tower’s Chief Compliance Officer, at Daniel.anders@towermsa.com or (888) 331-4941 with questions.