According to Dr. John Glaspy, director of UCLA’s Outpatient Oncology Clinic, one complicating factor, experts say, is that oncologists make significant revenue buying cancer drugs from manufacturers and charging patients a higher price for receiving the drugs in their offices. That profit motive could influence some doctors’ decisions.

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 for drugs, like the anemia medicines, which they dispense in their offices as part of treatment. Doctors receive the rebates after they buy the drugs from the companies. But they also receive reimbursement from Medicare or private insurers for the drugs, often at a markup over the doctors’ purchase price.

U.S. Oncology reported in their lastest SEC Form 10-K that they will bank $8-10 million a year less than expected because they are suddenly giving a lot less anemia drugs. They got caught with their hands in the cookie jar!

It’s still your mother’s chemotherapy drug concession. Although the new Medicare bill tried to curtail the drug concession, private insurers still go along with it. The core activity in medical oncology is the provision of infusional therapy. The entire structure of office-based practices revolves around this activity and is what distinguishes medical oncology from most other specialties.

What needs to be done is to remove the profit incentive from the choice of drug treatments. Patients should receive what is best for them and not what is best for their physicians. Let’s take physicians out of the retail pharmacy business and force them to be physicians again!

A Cure for What Ails the FDA

http://www.law.com/jsp/article.jsp?id=1182503155456

Gregory D. Pawelski