Reimbursement Incentives and Oncology Practice

[Hazelgreen]

For those of you who have mentioned concerns about big Pharmacare, here is a reference to a brief article, dated January 3, 2019, in the Journal of the American Medical Association (JAMA) - Oncology:

JAMA Oncol. 2019;5(6):893-899

The question to be answered was, "Do the financial incentives within oncology reimbursement affect physicians' practice patterns?"

The main finding: "In this systematic review of 18 studies....most studies found evidence of an association between reimbursement incentives and delivery of cancer care. The ability to self-refer for radiation oncology services was associated with increased use of radiotherapy, and greater profitability of an anticancer drug was associated with increased use of that drug."

[Justme153]

This is really sad! I'm glad the doctors where at least honest enough to admit it!! I do think we need to look at this with a grain of salt. I'm sure that if there are two drugs out there that a doctor feels will work for a person and he has to decide what one to prescribe. That if one is going to put some extra money in his pocket that this is what makes his decision!! In which case it's not as bad as it sounds. And we all know when you fill out questionnaires it yes no or maybe no way to explain yourself. So doctors in this study could simply be saying if you give us an incentive to prescribe your drug and it's a decision between your drug and another of equal efficacy I will choose the drug with incentive!!

[Hazelgreen in reply to Justme153]

That makes sense, and is certainly a good way to look at it. I was interested in the fact that a well-recognized American journal published this article, which referred to 18 studies looking into the matter. It seems to me that this is likely a wide-spread and well-known issue.

My husband recalls a golf date with a drug rep and a psychiatrist friend. He said it was clear the drug rep was pushing his company's latest product, and our friend acknowledged that was why the rep paid the course fees. Of course, this did not mean our friend prescribed the product, but it did mean that he heard all about the reasons to prescribe it.

[diamags]

I'm happy to say that my onc is not swayed. I'm on a drug regimen that's way old (like from the 1980s) that is working and he won't consider changing until it stops.. I guarantee that he's not making any money from it!

[Hazelgreen in reply to diamags]

I'm glad to hear that someone else is on an old regimen. I'd be interested to know whether it is tamoxifen, another antiestrogen, or an estrogen derivative.Thanks,

Cindy

[diamags in reply to Hazelgreen]

I get monthly Faslodex shots, daily arimidex pill and xgeva. I started on this before Ibrance was approved by the FDA. It has worked really well for me, but I am an outlier on how long it has worked.

[Hazelgreen in reply to diamags]

Thanks for the information. However, I don't think any of these treatments were available before 2000. I'm glad this regimen has worked for you. How long has it been so far?

[diamags in reply to Hazelgreen]

7 years and change! I just got my latest scan results yesterday, no progression! YAY.😊

[Hazelgreen in reply to diamags]

Wow! Good for you! I'm hoping tamoxifen will work as long, even at my age (75)!

[diamags in reply to Hazelgreen]

Me too!

[Hazelgreen in reply to diamags]

Thanks!

[Lilykristymichael in reply to diamags]

Please tell us what drug you are on. Thank you.-Madlyn

[Hazelgreen in reply to Lilykristymichael]

Just read the responses given above. I am on tamoxifen, and Diamags "monthly Faslodex shots, daily arimidex pill and xgeva".

[mswheeze]

It’s important to not lump every doctor you come in contact with as practicing anything w/an element of motivational greed. It is unfair and reckless to make such generalized assertions/assumptions.

Yes, there might be doctors who do practice for selfish reasons. I’m stressing don’t assume automatically that every doctor you meet, or not meet, is doing this. It’s completely biased and unfair!

If you’re concerned your doctor is doing this, ask them.