OIG Reports Q4 2025 Drug Pricing Comparison Data for Medicare Part B
The HHS Office of Inspector General released its quarterly comparison of Average Sales Prices (ASP) and Average Manufacturer Prices (AMP) for drugs covered under Medicare Part B for the fourth quarter of 2025. This routine report tracks whether ASPs exceed AMPs by specified thresholds, which can trigger federal payment adjustments under the Deficit Reduction Act. The data covers physician-administered drugs reimbursed through Medicare Part B fee-for-service, not Medicaid managed care pharmacy benefits. These quarterly reports are published regularly and do not indicate new policy changes or enforcement actions.
This Medicare Part B pricing report has no direct operational impact on Medicaid managed care organizations, which use different reimbursement methodologies for physician-administered drugs and do not rely on ASP-based pricing for covered pharmacy benefits.
Pharmacy
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