How many people were surprised by this finding?

How many people were surprised by this finding?

A study in Health Affairs demonstrates that oncologists decided which chemotherapy regimens to administer based on what level of profits they could make on the drugs. Is this surprising?

Before the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, Medicare reimbursed physicians for chemotherapy drugs at rates that greatly exceeded physicians’Â’ costs for those drugs. We examined the effect of physician reimbursement on chemotherapy treatment of Medicare beneficiaries older than age sixty-five with metastatic lung, breast, colorectal, or other gastrointestinal cancers between 1995 and 1998 (9,357 patients). A physician’s decision to administer chemotherapy to metastatic cancer patients was not measurably affected by higher reimbursement. Providers who were more generously reimbursed, however, prescribed more-costly chemotherapy regimens to metastatic breast, colorectal, and lung cancer patients.

See Does Reimbursement Influence Chemotherpay Treatment for Cancer Patients?

March 8, 2006

4 thoughts on “How many people were surprised by this finding?”

  1. I actually am a little surprised by this, David, on two counts.

    First, what oncologist buys his own drugs and resells them to patients? At most, he orders them in a hospital or out-patient IV treatment unit. At least he writes a script.

    Second, there’s so much EBM for oncology, if docs were willfully departing from protocols to make money, they’d stand out like a Yankee fan in Fenway Park.



  2. Flea, the data are from the mid-90s, when oncologists routinely made out by marking up their drug costs. From the article:

    Before 2004, Medicare reimbursed for chemotherapy drugs at the lesser of the billed charge or 95 percent of the average wholesale price (AWP) (100 percent before 1998). But oncologists and institutions purchased these drugs at prices well below the AWP. For example, in 1999 the average widely available discount to physicians was 12–30 percent of the AWP and reached as high as 86 percent.

  3. Well now. We’ve just gotten the news that psychiatrists have been on the take for years from the pharmaceutical companies when writing all the versions of the DSM and that all of their research was funded nearly entirely by pharmaceutical companies.

    It doesn’t make me have a lot of faith in psychiatry, especially when diagnostic criteria change whenever new drugs are introduced on the market.

    If the field of psychiatry had their way, everyone would be abnormal and in need of a pill to fix their disorder.

    The same thing has happened with normal blood pressure, cholesterol and blood sugar standards.

    The whole goddamned country seems to be in the WIIFM mode (What’s In It For Me) including healthcare.

    Managed care doesn’t care about sick people. They want WELL people but they won’t pay for the preventive medicine and followup requirements to keep them well.

    When you try to make profits from human suffering there is a moral disconnect in the process.

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