The Obama administration is trying a new system to try to prevent doctors from prescribing expensive drugs to medicare patients when a cheaper similar drug is available.
Doctors who are giving drugs to their patients in their office such as doctors treating eyes, cancer and arthritis are required by Medicare to purchase the drug and then to get a re-reimbursement from Medicare. When Medicare pays them back, doctors also receive an incentive of 6% of the cost of the drug. Therefore if doctors have a choice between a $50 drug or a $2,000 drug they may tempted to choose the most expensive one to make extra money.
Previous studies such as “Least Costly Alternative: Impact on Prostate Cancer Drugs Cover Under Medicare Part B” or “Does Reimbursement Influence Chemotherapy Treatment For Cancer” have shown that the actual Medicare system of reimbursement is indeed perversely encouraging doctors to prescribe the most expensive drug for their patients.
A test to be conducted by the Obama administration will compare the choices of doctors who are still payed 6% on the price of the drug they administered to their patient with the choices of doctors who will receive 2.5% of the drug price and a flat fee.
Some cancer doctors, especially the ones who are proposing a lot of newer and more expensive drugs and the pharmaceutical industry as well are infuriated by this new test because if this new system was implemented in the future, it will impact their revenue.
It is medical malpractice for a doctors to consider how much they make on a drug compared to another when prescribing a drug to a patient. Doctors should choose a drug based on what is the most medically appropriate for their patients not on profit considerations.
Read a complete article in the New York Times about this new Medicare test