Peter Ubel, MD Meds July 4, A recent economic analysis concluded that patients with metastatic cancer value their treatments significantly more than regulators recognize, with many expensive new therapies looking like veritable bargains to most patients.

Yet the study ignored the values really driving oncology spending—the warped incentives oncologists have to promote their own bottom line by prescribing expensive treatments. The USC team began its work with what seems like a reasonable assumption: This assumption is the basis for much economic thinking, and in most market contexts, it is a reasonable take on the situation.

Based on this assumption, the USC team looked at what patients were willing to pay out of pocket for cancer treatments, and calculated what value they placed on these treatments. They concluded that most cancer therapies, by this measure, are a bargain. For starters, the price of most medical treatments is not transparent to patients. In my book Critical Decisions coming out this fall HarperOne, SeptemberI write about the challenge of getting patients to share in their healthcare choices.

But briefly, the challenge of shared decision making is made steep by the emotions that often surround healthcare decisions. A patient who has just learned that he has metastatic cancer is probably not going to be emotionally prepared to do comparison shopping!

How do oncologists get money from chemo drugs? | Yahoo Answers

And that is where oncologic decision making gets really messy. Because in the United States, at least, many oncologists make a good deal of their income selling drugs to their patients.

Here is how it works. Oncologists purchase intravenous chemotherapy from pharmacies. Many private insurers pay even larger mark-ups, especially from oncology practices that dominate their local markets and thus have pricing leverage. Many oncologists vehemently deny being influenced by this financial conflict of interest. But such denials defy both logic and data.

Oncologists would have to be superhuman not to be influenced, at least unconsciously, by such strong incentives. In the face of such uncertainty, how could oncologists avoid being influenced by the knowledge that those promising expensive new treatments also help generate so much income? Indeed, a team of Harvard researchers examined lung cancer treatments both before and after changes in Medicare reimbursement procedures, changes that led to the 6 percent rule I discussed above.

Believe it or not, prior tooncologists made even more stock options seminars 6 percent profit on most of the treatments they prescribed. Based on the law, some chemotherapies became far less profitable for oncologists to prescribe. The Harvard team discovered that the percent of lung cancer patients receiving outpatient treatment grew dramatically after In effect, since oncologists were making less profit on each treatment they gave, they tried to make up for this loss in revenue by increasing their volume.

The Harvard team discovered a second thing too—that oncologists were more likely to prescribe docataxel than they were before the reimbursement changes, at the expense literally of cheaper drugs like paclitaxel. They shifted to the more expensive and more profitable drug. The USC team I described above did not cite this Harvard analysis. Perhaps they were so enamored of the idea that patients know what chemotherapy they want because, you know, patients are so well versed on the relative pros and cons of docataxel and paclitaxelthat they overlooked the likelihood that chemotherapy decisions are primarily made by oncologists.

If we want to get do oncologists make money on chemo drugs value out of medical care, we should pay for value. Giving physicians an incentive to prescribe expensive drugs is bad medicine. He is the author of Critical Decisions: How You and Your Doctor Can Make oakland raiders stock market Right Medical Gedik forex mobile Together.

Learn more about the book. Comments are moderated before they are published. Please read the comment policy. The elephant in the closet in health care?

Thank you and Dr. Ubel for recognizing the conflict in the inverted rsi strategy place. Sorry, this is stock market and democrats not possible. The sooner all of us, including public policy makers and voters, recognize that self-interest motivates all of us, doctor, patient, and elected official alike, the sooner we will be able to address conflicts of interest, not only in medicine, but everywhere we look.

A tiered system of legitimate markup should be a good option where the oncologists are not disadvantaged when prescribing generic or cheaper drugs, and not incentivised to prescribe expensive drugs.

Even then, it will be hard for oncologist when patients demand the latest drug in the closet. Get do oncologists make money on chemo drugs updates delivered to your inbox. About Contact Contribute Book Coaching Speaking. Do oncologists have an incentive to prescribe expensive treatments? Peter Ubel, MD Meds July 4, A recent economic analysis concluded that patients with metastatic cancer value their treatments significantly more than regulators recognize, with many expensive new therapies looking like veritable bargains to most patients.

Applying ADHD lessons to medical marijuana. July 4, Kevin 4. Take the time to educate yourself before forming an opinion. July 5, Kevin 6. Related Posts Are new cancer drugs really worth their price? Each has a price. Why are affordable drugs so expensive?

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