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Blog: Insurer offers doctors bonus for prescribing endorsed drugs
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An article in a recent Wall Street Journal describes a new payment incentive from WellPoint Health Insurance for oncologists treating breast cancer, in which doctors receive a $350 per month bonus payment for using an insurance-approved chemotherapy regimen. The approved regimen has been described by leading specialists in the field as reasonable for the majority of patients but is certainly not an ideal fit for everyone. Furthermore, oncology’s steadily growing array of genetically optimized treatment regimens — with varying degrees of proven success — would persuade at least some results-driven oncologists treating patients away from such conventional regimens.
It has long been illegal for doctors to receive payments from drug companies or other interested parties to prescribe certain brands of medications. Under the new Physicians Payment Sunshine Act, any significant payment to a physician from a drug or device company (but not a private insurance company) must be disclosed publicly.
But what ethical guidance do we have for an insurance company making substantial added payments to doctors to stick with traditional treatment approaches, guiding patients away from more modern, expensive regimens that hold hope for better results? My moral compass tells me that physicians should beware anytime any third party pays us more to prescribe a particular treatment. As Primary Care Optometry News Editor Michael D. DePaolis, OD, FAAO, has always advocated, if we ask ourselves what is in the patient’s best interests, we will almost always come up with the best course of action.
I welcome your comments about this emerging trend in medical care.
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