Medicare’s Failure to Track Doctors Wastes Billions on Name-Brand Drugs – ProPublica

Medicare is wasting hundreds of millions of dollars a year by failing to rein in doctors who routinely give patients pricey name-brand drugs when cheaper generic alternatives are available.

ProPublica analyzed the prescribing habits of 1.6 million practitioners nationwide and found that a tiny fraction of them are having an outsized impact on spending in Medicare’s massive drug program.

Five Takeaways

Medicare has failed to track doctors who most heavily prescribe costly name-brand drugs instead of cheaper generics. Just 913 doctors could have saved taxpayers $300M in 2011 by prescribing more like their peers.

Nearly half of these big name-brand prescribers have accepted thousands of dollars in promotional or consulting fees from drug makers in recent years.

Medicare’s low-income subsidy encourages wasteful name-brand prescribing by keeping co-pays so low that there is little incentive to request a generic. Congress has declined to take up a fix proposed in President Obama’s budget.

This ballooning low-income subsidy accounted for one-third of the $62 billion taxpayers spent last year on the Medicare drug program, called Part D.

The U.S. military, the Department of Veterans Affairs and some private health plans put limits on name-brand prescribing, but Medicare Part D hasn’t followed suit.

Just 913 internists, family medicine and general practice physicians cost taxpayers an extra $300 million in 2011 alone by disproportionately choosing name-brand drugs. These doctors each wrote at least 5,000 prescriptions that year, including refills, and ranked among the program’s most prolific prescribers.

Many of these physicians also have accepted thousands of dollars in promotional or consulting fees from drug companies, records show.

via Medicare’s Failure to Track Doctors Wastes Billions on Name-Brand Drugs – ProPublica.