OBR Daily Commentary - Multiple Myeloma

forumImage

Oncologists Getting 6% of Drug Price Is 'Financial Conflict'

(Medscape Medical News) Mar 7, 2018 - "No one is immune from $ temptation.... We have a system that rewards oncologists and their chemotherapy offices with more $ for giving more expensive chemo. This has to change," said Vincent Rajkumar, MD, a professor of medicine and a hematologist/oncologist at the Mayo Clinic, Rochester, Minnesota.

Thomas Marsland, MD (Posted: March 14, 2018)

quotesDrug pricing and the costs of medications is clearly an ongoing problem. But as always, this report puts the blame on the oncologist. First and foremost, we the physicians do not control drug prices. That falls on pharma. The margin that oncologist make is really just a very small piece of the overall drug costs. The author picks on two specific drugs in this article, but really fails to look at the total drug revenue to practices. There are many drugs that are actually money losers at the current pricing program. In the end, at least at Medicare reimbursement rates, drugs overall are at best a pass though. The private practice of medical oncology is not a non-profit business, although we compete with non profits who clearly have been shown to make much larger "profits" though the widespread mis-uses of the 340B program (addressed in many other forums). Practices maintain an expensive infrastructure on infusion suites, admixture facilities, and highly trained staff to provide high quality services at what I might point out is less costly than similar hospital-based programs. So yeah I'm not a charity, yes I look at drug prices, but that is needed to keep the doors open. I am anxiously awaiting the new, better system. quotes

Read Article arrow
Add Comment 3 Comment
forumImage

Oncologists Getting 6% of Drug Price Is 'Financial Conflict'

(Medscape Medical News) Mar 7, 2018 - "No one is immune from $ temptation.... We have a system that rewards oncologists and their chemotherapy offices with more $ for giving more expensive chemo. This has to change," said Vincent Rajkumar, MD, a professor of medicine and a hematologist/oncologist at the Mayo Clinic, Rochester, Minnesota.

Jeff Patton, M.D. (Posted: March 07, 2018)

quotesThere are certainly some perverse incentives in medicine but there is a significant literature that community oncologist "who own their own infusion suites" prescribe the same medications even if the financial incentives are removed. There is also published literature, that institutions like the Mayo Clinic that are enrolled in the 340B government discount program where there financial incentives are 40-50% not 6%, prescribe more expensive therapies than their colleagues in the community. Dr. Rajkumar lives in a glass house and should check the facts before impugning others.quotes

Read Article arrow
Add Comment 3 Comment
forumImage

Oncologists Getting 6% of Drug Price Is 'Financial Conflict'

(Medscape Medical News) Mar 7, 2018 - "No one is immune from $ temptation.... We have a system that rewards oncologists and their chemotherapy offices with more $ for giving more expensive chemo. This has to change," said Vincent Rajkumar, MD, a professor of medicine and a hematologist/oncologist at the Mayo Clinic, Rochester, Minnesota.

Dean Gesme, MD (Posted: March 07, 2018)

quotesI respect Dr Rajkumar's clinical expertise but here in MN we have a 2% state drug tax as well as the federal government's 2% sequester; hence ASP plus 6% is totally illusory. The 1.8% net margin is insufficent to cover drug ordering, wastage, bad debt and pharmacy overhead unless they were being subsidized by 340b rebates! Thus 340b rebates may be the real perverse inducement and not "ASP plus 6%".quotes

Read Article arrow
Add Comment 3 Comment

Meet the Editorial Board

Prostate Cancer
member photo
Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
member photo
Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
member photo
Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
member photo
H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
member photo
Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
member photo
Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
member photo
Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
member photo
Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
member photo
Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
member photo
Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
member photo
Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
member photo
Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
member photo
Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
member photo
William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
member photo
William McGivney, PhD

National Health Policy Expert...

Payer
member photo
Winston Wong, PharmD

President, W-Squared Group...