How much do you think that price impacts the way that CTPs (skin subs) are selected in the office setting? One reader sent me this thought – which is testable statistically (although I do not have access to the data to do it):

“Dr. Fife,

I could be wrong, but I think the apparent problem with CTP selection is mostly (though not entirely) with the system that sets prices — not how it is being billed by individual offices. 

It would be interesting to see the data, but here is what I would expect to see based on what I hear:

  • The products with reported but high ASPs (Average Sales Price) are relatively popular in the office setting everywhere.
  • The products with unreported ASPs are popular in the office in those MACs that set reimbursement based on WAC (Wholesale Acquisition Price), not invoice.
    • Roughly speaking I think the “WAC MACs” are Novitas, First Coast, Palmetto and WPS
  • Unreported products are not very popular in the office in the MACs that pay only on invoice price, like Noridian.

I know the older data showed a big surge in the unreported products [products without a reported ASP] but that was before CMS started publishing so many ASPs resulting in high priced products being on the ASP list. That changed the game somewhat.”

[Name withheld]

What do you think?