April 09, 2014
Your Congress at Work

As The Washington Post reported in December:

The story of Avastin and Lucentis, two nearly identical drugs for blindness, offer a glimpse into the problematic world of Medicare pricing.

A dose of Avastin costs only $50. A dose of Lucentis costs $2,000. Both Avastin and Lucentis are made by the same company, and they're remarkably effective in treating a form of macular degeneration that was long the leading cause of blindness among the elderly, The Post reported. They are very similar on a molecular level and probably cost about the same amount to manufacture.

Nonetheless, doctors prescribe Lucentis almost as often as Avastin. They also make more money doing so. Medicare is legally obliged to pay for any drug a doctor prescribes, and doctors also receive commissions of 6 percent to cover their own expenses. The commission a doctor collects on each dose of Avastin would be only about $3, as opposed to $120 on each dose of Lucentis. Congress and the courts have refused to allow Medicare to save money by scrutinizing doctors' decisions.

As a result, taxpayers spent about $1 billion in 2012 more than they would have if doctors had been prescribing Avastin. Avastin, for all intents and purposes, has been shown to be equivalent to Lucentis in six studies and one massive review of Medicare records.


Posted by Jerome Doolittle at April 09, 2014 05:19 PM
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What "expense" is there to the Dr. in prescribing a med? They enter them on the computer now, so they don't even have to buy Rx pads or 20-cent pens! Is this commission thingy statutory or a reg? If the latter, the admin could change it pronto.

Posted by: Tim on April 10, 2014 12:18 AM

B-b-b-b-but...but...but scrutinizing the prescriptions doctors write would be DEATH PANELS!!
It would be the end of FREEDOM AS WE KNOW IT!!! It would be the govmint getting between sick people and the God-given right of drug companies to bribe doctors and maximize their own corporate profits, which would be dehumanizing, on account of corporations are people.

This kind of evil thinking must stop. If we don't want the govmint spending big sums on drugs, the solution is easy. Eliminate Medicare.

Anyway, that's what my Teaparty friend told me.

Yours very crankily,
The New York Crank

Posted by: The New York Crank on April 10, 2014 12:57 PM

Government not allowed to bargain for drug prices because ... Congress.

Posted by: on April 10, 2014 11:09 PM
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