Why do they put nails in coffins?
To stop oncologists from giving chemotherapy!
This is a guest article from an anonymous pharmaceutical drug rep:
If you have cancer, a big factor in your chemo decision is profit. Medical Oncologists are the cancer doctors that give chemotherapy.
Most of them are in group practices that buy intravenous drugs from specialty wholesalers.
When it's time for your treatment, a nurse will 'hang a bag' on the IV pole near your treatment chair and start dripping chemo into your veins.
The office then bills insurance (80%) and collects your co-pay (20%). Medical oncologists make money by 'keeping the chairs filled'.
Recent changes to Medicare limit drug profits to about 6%. If physicians buy $1,000 worth of drug they are reimbursed $1,060.
This is enough to cover costs and make a modest profit. Every quarter, Medicare reimbursement rates for chemotherapy change. Office managers compare these rates with acquisition costs and recommend agents to avoid or take advantage of.
There are a two other problems with this system:
- If a physician's yield is constant they are inclined to use more expensive drugs, even if they have the same therapeutic effect. For example, the $6,000 profit of a $100,000 drug is much higher than the $60 profit from a $1,000 drug. Insurance companies and patients pay the difference.
- In order to make money, physicians must collect co-payments. Conversely, they lose money if they don't collect co-payments. Let's say a patient doesn't cough up his $212 co-pay for a $1,000 drug. Even if a physician gets $848 from Medicare, he just lost $152 in the transaction.
Do you think he's going to use an even more expensive drug? Even one that could be more effective? Not unless they collect that co-payment up front.
- Bottom line? If your medical oncologist is confident that you can make your co-payments, you'll get the most expensive drugs on the market whether you need them or not.
There's an old joke: Why do they put nails in coffins? They do it to stop medical oncologists from giving chemotherapy. I guess now it depends on whether or not the dead can afford their co-payments.