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To calculate the reduced total rebate amount for a Part B rebatable drug, in 427.401(b), CMS proposes the following formula: Reduced Total Rebate Amount = total rebate amount multiplied by (1 minus applicable percent reduction) multiplied by (percentage of time drug was currently in shortage during the calendar quarter) added to the total rebate amount multiplied by (1 minus percentage of time drug was currently in shortage during the calendar quarter) For the purpose of this formula, for a Part B rebatable drug that is a plasma-derived product, in 427.401(b)(2)(i), CMS proposes an applicable percent reduction of 75 percent for the first 4 consecutive calendar quarters such Part B rebatable drug is currently in shortage, 50 percent for the second 4 consecutive calendar quarters, and 25 percent for each subsequent calendar quarter

Acknowledgements We are extremely grateful to Mr

doi: 10.18637/jss.v045.i03 28

Participating study populations were included based on reliable local facilities of the state commune health station in Hanoi city and the neighboring provinces of Hung Yen and Phu Tho