Monday, April 01, 2019

Drug-maker payments to doctors may influence choice of what drugs to prescribe; that can cost patients real money

If your doctor is prescribing an expensive drug, you might want to consider alternatives, and check to see if the physician has been taking money from the company that makes the drug, Trudy Lieberman of Rural Health News Service suggests in her latest column. As she often does, Liberman tells the story through a patient, a 94-year-old Indiana woman "who is rapidly spending down her minimal savings to pay for prescription drugs," according to her daughter, Peggy, who wrote to Lieberman.

"Peggy said that every time her mom visited the physician, the doctor told her she was lucky to take the expensive blood thinner instead of the other 'stuff' which he called 'rat poison,' implying a cheaper drug was inferior, even dangerous," Lieberman writes. "Then a family member discovered openpaymentsdata.cms.gov," a Medicare database that shows what doctors get from makers of drugs and medical devices in speaking, research and consulting fees, and for food and drink expenses.

"Her mom’s cardiologist had received nearly $80,000. Peggy had a bad feeling about the doctor, and switched her mom to another physician who kept her on the high-priced drug for two months. Then she was diagnosed with anemia, taken off blood thinners and prescribed low-dose aspirin. In the meantime, Peggy’s husband had a heart attack and developed a blood clot. His doctor prescribed a low-cost blood thinner that’s been on the market for years. She said he’s doing just fine on the 'rat poison' disparaged by her mother’s first doctor. His cost: a $6 copay every 30 days."

However, "The drug-and-device database may be one of health care’s best-kept secrets," Lieberman writes, noting a study that found only 3 percent of patients "knew their doctor had received payments from the medical industry. Unlike Peggy’s family, they had no idea that Medicare’s Open Payments database existed. . . . Peggy had some advice of her own: 'Do the research. Did the doctor receive money to push the drug? Ask questions? How much does the drug cost? Is it really a better alternative?'"

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