Among cancer doctors, it is called the chemotherapy concession. As overall spending on prescription drugs soars, cancer specialists pocket hundreds of millions of dollars each year by selling drugs to patients–a practice that almost no other doctors follow.
The cancer specialists can make huge sums from the difference between what they pay for drugs and what they charge insurers and government programs. Some private health insurers are studying ways to reduce these profits, and the issue is getting attention in Congress.
Typically, doctors give patients prescriptions for drugs that are then filled at pharmacies. But cancer doctors, or oncologists, buy the chemotherapy drugs themselves, often at prices discounted by drugmakers trying to sell more of their products, and then administer them intravenously to patients in their offices.
Cancer specialists have resisted most government efforts to take away the drug concession, arguing that they need the payments to offset high costs in the rest of their practices. But support for change is growing.
“This has gotten out of hand,” said Dr. William Popik, the chief medical officer for Aetna, which is exploring different approaches to the concession, including taking it away in some regions.
Medicare, which does not cover most prescription drugs, pays doctors about $6.5 billion a year for drugs they administer, largely for cancer. Some estimates say that the government is paying more than $1 billion over the actual cost for drugs.
Rep. Pete Stark (D-Calif.) introduced legislation this month that would pay oncologists more for their services while reining in the charges for drug costs.
