Giveaway to Big Pharma

This is a confusing mishmash.I got a letter yesterday stating that 3 of my patients had prescriptions written by me that were honored THIS TIME but in the future,I will need to preauthorize the scripts with their plan.And what intricate drug did Iprescribe these folks?A TOPICAL ANTIFUNGAL!!!A less effective antifungal can be prescribed by me without prior authorization.These people used to have either Medicare or Medicaid cover the drugs.Where Bush erred was that he made it mandatory for these people(but not all:if you have better Drug coverage than Medicare D,you can keep it).All it seems like is an exercise in futility.

Another big government initiative to fulfill a campaign promise- this program is going to end up costing trillions and doing very little to improve the medicare system.

Changing the Identity of Medical Oncology Under Medicare The new Medicare Modernization Act of 2003 changed how the CMS pays for doctor-administered drugs to a system based on doctors' costs for the drugs from one based on average wholesale price. Medical oncologists will be reimbursed for providing evaluation and management services, making referrals for diagnostic testing, radiation therapy, surgery and other procedures as necessary, and offer any other support needed to reduce patient morbidity and extend patient survival. According to the Government Accountability Office (GAO), oncologists will see a net increase in Medicare revenue for oncology drugs, their preparation and their administration in 2004 and 2005, despite reduced payments for certain drugs. Providers feared the change would represent significant reimbursement cuts. However, the GAO said that in a review of 17 drugs, Medicare rates would exceed physician costs by 22% in 2004 and by 6% in 2005. The fact that these medical oncologists received no reimbursement for providing oral-dose therapy to patients had been the principal barrier to the availability of oral-dose protocol. The advent of oral agents ultimately means that medical oncology will need to change its identity, prior to the chemotherapy drug concession. Because oral-dose drugs hold the promise of being more selective, harming fewer normal cells, reducing side-effects and work to improve the quality of life for people with cancer, they will rightfully gain their appropriate share of the marketplace, again. The new Medicare Bill offers patients benefits they did not have before, mainly some coverage for oral chemotherapy drugs. Since April of 2004, $200 million was available so that some Medicare cancer patients would have transitional coverage for these drugs, until the bill goes into full effect in 2006. Although some benefit was realized, more might have been achieved if the American Society of Clinical Oncology and other groups had lobbied as much for the oral chemotherapy drug issue as they did for office-practice expense reimbursement. They fought long and hard to retain the Chemotherapy Drug Concession. Increasingly, oral-dose anti-cancer drugs are found to treat cancer effectively and seen as a necessary part of a patient's cancer care. A number of these breakthrough cancer drugs came on to the market that are only in oral form and previously not reimbursed under Medicare. Patients were being forced to compromise their cancer care due to Medicare not covering many of these life-saving therapies. The new legislation started the process of providing access to a full range of the latest cancer-related prescription drugs at manageable costs to enhance the quality and standard of treatment for cancer. Medicare recipients were being relagated to treating their diseases with older, more toxic infusional chemotherapy agents at a time when new and more promising cancer drugs were reaching the market. Compared to infusional therapy, oral-dose anti-cancer drugs can make receiving cancer treatment more convenient for patients by allowing flexibility in taking medication without disrupting work or other activities. They can often result in less time (or no time) spent in office-based oncology practices because of the absence of intravenous administration and its related side-effects. Targeted cancer therapies will give doctors a better way to tailor cancer treatment. There are a multiple of different cancer drug regimens, all of which have approximately the same probability of working. Treatments may be individualized based on the unique set of molecular targets produced by the patient's tumor, and these important treatment advances will require individualizing treatment based on testing the individual properties of each patient's cancer. What was needed, was to remove the profit incentive from the choice of cancer treatments, which were financial incentives for infusion therapy over oral therapy or non-chemotherapy, and financial incentives for choosing some drugs over others. Patients should receive what is best for them and not what is best for their oncologists. The new system is clearly an improvement from the standpoint of cancer patients, taxpayers, and advocates of basing drug selection on individual tumor biology, rather than on a least common denominator approach which invites conflict-of-interest medical decision-making. It is time to set aside empiric one-size-fits-all treatment in favor of recognizing that many forms of cancer represent heterogenous diseases, where the tumors of different patients have different responses to chemotherapy. It requires individualized treatment based on testing the individual properties of each patient's cancer. Source: Human Tumor Assay Journal Gregory D. Pawelski

OMFG! Why did he DO this to us????

If this is a fire-break tactic, only time will attest to it's efficacy.

There are several problems with this initiative, although it is well-intentioned: (1) it is hardly comprehensive coverage; (2) it doesn't take effect until 2006, which is retarded: why pass legislation that's supposed to benefit the people, yet earmark its start-up two years down the line?; (3) it's going to cost the taxpayers hundreds of billions of dollars more than originally projected, which is typical of Bush II free-spending initiatives; and (4) it's really nothing more than a get-over for the pharmaceutical industry, as if that industry needs any more get-overs than it already enjoys. This is just another windowdressing initiative by a most inept administration, a wan and feeble program that is hardly even a sound first step toward solving an onerous national problem. This is yet another limp companion to the clueless policy and toothless legislation offered up by the Pretender-In-Chief and his imbecilic minions.