http://healthblog.ncpa.org/this-is-the-agency-that-is-going-to-bend-the-cost-curve/ Health Care Policy and Reform Insights | NCPA Fri, 25 May 2012 14:14:04 +0000 hourly 1 http://wordpress.org/?v=3.3.2 http://healthblog.ncpa.org/this-is-the-agency-that-is-going-to-bend-the-cost-curve/comment-page-1/#comment-47044 Timothy O'Shea Thu, 15 Oct 2009 02:42:56 +0000 http://www.john-goodman-blog.com/?p=5918#comment-47044 Some physicians chose to use Avastin in the eye despite the lack of large, prospective, well-controlled, randomized safety and efficacy studies (all of which exist for Lucentis). Rather than treating patients using level 1, evidence based medicine, the choice was made to use personal clinical experience and small case study series to justify using an unapproved (for ocular usage) colorectal cancer drug in the eyes of patients. This choice was made because Avastin could be aliquoted down into tiny, inexpensive doses which saved money for the patient, and was less expensive for the physician to stock. Now that some bizarre Medicare pronouncement has made it financially distasteful for physicians to inject Avastin (potentially decreasing revenue between 10 - 42 dollars for each injection than was previously realized), all of a sudden everyone is going to start injecting Lucentis?!? What happened to giving patients the best possible treatment? What happened to evidence-based medicine? Are we self-rationing care and looking for the cheapest way out already, even before the powers that be force us to do it?!? Shame on everyone making treatment decisions based on reimbursement rates and not data. Some physicians chose to use Avastin in the eye despite the lack of large, prospective, well-controlled, randomized safety and efficacy studies (all of which exist for Lucentis). Rather than treating patients using level 1, evidence based medicine, the choice was made to use personal clinical experience and small case study series to justify using an unapproved (for ocular usage) colorectal cancer drug in the eyes of patients. This choice was made because Avastin could be aliquoted down into tiny, inexpensive doses which saved money for the patient, and was less expensive for the physician to stock. Now that some bizarre Medicare pronouncement has made it financially distasteful for physicians to inject Avastin (potentially decreasing revenue between 10 – 42 dollars for each injection than was previously realized), all of a sudden everyone is going to start injecting Lucentis?!? What happened to giving patients the best possible treatment? What happened to evidence-based medicine? Are we self-rationing care and looking for the cheapest way out already, even before the powers that be force us to do it?!? Shame on everyone making treatment decisions based on reimbursement rates and not data.

]]> http://healthblog.ncpa.org/this-is-the-agency-that-is-going-to-bend-the-cost-curve/comment-page-1/#comment-47016 Devon Herrick Wed, 14 Oct 2009 16:45:31 +0000 http://www.john-goodman-blog.com/?p=5918#comment-47016 I recall when doctors first figured out that Avastin could also be used for eye disease. The drug maker was concerned about how to price the drug when the dose for an eye was a small fraction of the dose for cancer. Drug makers generally like to keep the price of a given drug therapy similar regardless of dose. The drug maker shouldn’t have been concerned. Medicare will drive doctors to the higher-priced dose. I recall when doctors first figured out that Avastin could also be used for eye disease. The drug maker was concerned about how to price the drug when the dose for an eye was a small fraction of the dose for cancer. Drug makers generally like to keep the price of a given drug therapy similar regardless of dose. The drug maker shouldn’t have been concerned. Medicare will drive doctors to the higher-priced dose.

]]> http://healthblog.ncpa.org/this-is-the-agency-that-is-going-to-bend-the-cost-curve/comment-page-1/#comment-47009 Larry C. Wed, 14 Oct 2009 15:13:01 +0000 http://www.john-goodman-blog.com/?p=5918#comment-47009 I agree with Stephen. I agree with Stephen.

]]> http://healthblog.ncpa.org/this-is-the-agency-that-is-going-to-bend-the-cost-curve/comment-page-1/#comment-47006 Stephen C. Wed, 14 Oct 2009 14:57:55 +0000 http://www.john-goodman-blog.com/?p=5918#comment-47006 Sounds like bureaucracy as usual. Sounds like bureaucracy as usual.

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