Physicians

PHARMA/PHYSICIANS: ESRD centers having the curtain pulled back

The NY Times shows that apparently doctors owning ESRD centers and others running chemo-infusions centers reap millions for Anemia drugs .
Who knew? OK, anyone reading THCB for the past few years knows all about this, but now that it’s hitting the NY Times (which got a former clinic director to open his version of the books showing that docs in a 6 person group made about $450K a year each on their sale of the drugs) and now that hearings have already been held, and the FDA’s issued a warning, perhaps something may change…

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balaRonhchcecjohndoeRavenor Recent comment authors
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bala
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bala

hai good morning

Ron
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Gregory, Excellent post on how to handle a situation such as this.

Gregory D. Pawelski
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Gregory D. Pawelski

I couldn’t agree more. A patient wants a physician’s decision to be based on experience, clinical information, new basic science insights, etc., not on how much money the doctor gets to keep. If you are a patient, you should know if there are any financial incentives at work in determining what cancer drugs you are being prescribed. Ask your oncologist: Why are you prescribing these drugs? What is their published efficacy and toxicity in other patients with the same cancer? Do you have any research or financial interests in prescribing these drugs? Are these drugs a profit center for you… Read more »

hchcec
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hchcec

As patients, you don’t need to be distrustful (but you might get the feeling from the posts of the chemotherapy -for-profit bloggers that that is what you are inevitably up against) but it’s wise to be savvy and take some practical steps. The most practical: -Seek second opinions. -Choose a health plan with as much flexibility about second opinions as you can. -Ask your physician to share with you the study results that informed his or her recommendation to prescribe a particular drug or chemotherapy regimen. You need not fear that your doctor sees $$$ when he examines you. If… Read more »

Gregory D. Pawelski
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Gregory D. Pawelski

U.S. Oncology took a hit on first-quarter reports showing a net loss. U.S. Oncology said a number of factors impacted the results, including reduced pre-tax income due to lower use of certain supportive care drugs used to treat cancer-induced anemia (their hands were caught in the cookie jar), and the discontinuation of the Medicare Demonstration Project. http://www.bizjournals.com/houston/stories/2007/04/30/daily82.html?from_rss=1 One key point was outlined in the NYT story: Federal laws bar drug companies from paying doctors to prescribe medicines that are given in pill form and purchased by patients from pharmacies. But companies can rebate part of the price that doctors pay… Read more »

hchcec
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hchcec

Dr. Paul Scheel, director of nephrology at Johns Hopkins University Medical Center, said he doesn’t believe that doctors are turning over prescribing decisions to dialysis centers or are unaware of dosing. As someone who’s worked with two dialysis chains, he said he has never been encouraged to use Epogen inappropriately. Dr. Charles McAllister, chief medical officer for DaVita, said the company’s dosing guidelines “are based on clinical science and really are done in an open collaborative atmosphere with physicians. The decision to use a guideline is purely that of the physician alone.” http://www.saukvalley.com/articles/2007/04/24/features/health_and_medical/334231970284003.txt Michael Lazarus , medical director of Fresenius… Read more »

johndoe
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johndoe
Ravenor
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Thanks for the additional info, GDP. I was amazed by this story. In addition to the finding that the drug is apparently useless according to the FDA report, another issue is that due to the volume discounts doctors get, patients likely get charged differently for this drug depending on whether their doctor does a lot of therapy for patients with this condition or not. I posted some more analysis of this over at US health care system massively fouled up–example.

Gregory D. Pawelski
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Gregory D. Pawelski

U.S. Oncology reports two seeming unrelated bits in their latest SEC Form 10-K. One note says cancer patients are suddenly using a lot less anemia drugs, and as a result U.S. Oncology will bank $8-10 million a year less than expected. In panel discussion that highlighted the 12th annual conference of the National Comprehensive Cancer Network, Lee Newcomer, former chief medical officer and currently an executive with Minneapolis-based United Health Group, pointed out that in reviewing records of patients who were prescribed the drug erythropoietin, said that 44% of those patients had blood work-ups that would indicate they were not… Read more »