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$1.1 Billion in Drug, Device Payments to Doctors Not Included in New US Database

The new Open Payments database of industry payments to doctors and teaching hospitals is more incomplete than previously known

 

The US government's new database of drug and device industry payments to doctors is even more incomplete than has been reported previously.


In a fact sheet posted online, federal officials disclosed that the database, dubbed Open Payments, is missing more than $1 billion in payments made between August and December 2013. These omissions are in addition to information the government has redacted from the payments it has disclosed, citing inconsistencies.


Open Payments was unveiled last week and included data on 4.4 million payments valued at $3.5 billion. More than half a million doctors and about 1,360 teaching hospitals received at least one payment.


The Centers for Medicare and Medicaid Services, the agency overseeing the database, had said last week that it was not publishing any details on 9,000 payments that had been disputed by doctors or hospitals because those disputes hadn't been resolved. It also said it would withhold data on 190,000 research payments related to drugs and devices that are not yet on the market, as is mandated by law.


On a conference call with reporters, though, federal officials did not disclose that the unpublished data amounted to almost a quarter of the money drug and device makers dispensed in the final five months of last year.


That so much data is missing has been among the primary complaints lodged about Open Payments. The government withheld the names of doctors and hospitals associated with 40 percent of published payments and promised to disclose this information next year once it has been corrected and verified.


Early reviews of the Open Payments website, including our own, also have noted how difficult it is for consumers to use. In addition, doctors and pharmaceutical companies have been critical of the government for not being willing to immediately correct errors identified in the database, the Wall Street Journal reported. The government plans to correct them next year.

 

Courtesy: ProPublica.org

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Americans to get 10 year visa, PIO cards validity extended for lifetime

According to a Gazette notification, US nationals would be provided a 10-year visa for India, while the PIO card would remain valid for the lifetime of the cardholder

 

The Indian government on Tuesday decided to give a 10-year visa to US nationals while extending the validity of person of Indian origin (PIO) cards to lifetime from 15 years. This follows announcements made by Prime Minister Narendra Modi during his US visit.

 

"Fulfilling yet another announcement made by the Prime Minister, instructions have been issued to Embassies and Consulates that unless there are exceptional circumstances, visas to US nationals should normally be given for 10 years. Systems are in place to introduce visa on arrival for US tourists in October itself," government said in a release.

 

According to a Gazette notification issued on 30 September 2014, all PIO cards are now valid for the lifetime of the cardholder, instead of 15 years. In addition, the PIOs would be exempt from police reporting. In the same notification, the Ministry of Home Affairs (MHS) issued instructions stating that PIO cardholders would not be required to report to a police station even if their visit to India exceeds 180 days.

 

PM Modi made a number of announcements on consular and visa issues during his address at the Madison Square Garden in New York City on 28 September 2014.

 

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COMMENTS

Gopalakrishnan T V

3 years ago

The Government has acted very fast and this should be appreciated.

Patients may survive diseases, but will be killed by drug pricing of Big Pharma
Treatments like cancer cost so much money that the patient may often lose every asset he has built over the course of his or her life. Are these prices justified and reasonable? A new report by CBS 60 Minutes asks
 
The latest 60 Minutes episode on the CBS network takes on extortionist pricing of big-pharma for medicines such as for cancer. Not only does the show attack the exorbitant pricing of the drugs, it also dissects the practise that guides prescriptions by doctors and clinics for patients suffering from Cancer.
 
In a shocking report, CBS showed that a new drug with much the same efficacy and properties as another older drug in the market was being priced twice the amount of money. In treatments for diseases like Cancer, patients often need to take more than one drug or what is often termed a “drug cocktail.”
 
The report says that drug companies work at two levels to push drugs which are unreasonably priced. In the US pharma companies lobbied to create a legal framework where they could price drugs anyway they want. This specific cases shows up claims of Patent holders who cry foul about having to recover research costs. If a drug was being sold for $5000 and was recovering its costs, why does the newer drug with much the same properties need double the price to recover its costs.
 
But the fact remains that there is no known method to arrive at a reasonable profit margin and this is the extreme end of a free market system that has gone out of government control. The way the current market works is to charge whatever they can get the market to pay. So to get these over-priced drugs pushed through the market, pharma companies pay commissions to doctors for every prescription using the more expensive drug. Doctors are effectively incentivised like salespeople to act for the pharma companies.
 
Readers will recollect that our very own Dr BM Hegde has been writing against the crooked practices of Big Pharma companies and the pharmaceuticals industry in general for a long time in Moneylife. “The global pharma industry has racked up fines of more than $11billion in the past three years for criminal wrongdoing. The scale of the wrongdoing has undermined public and professional trust in the industry and is holding back clinical progress,” he writes here.
 
Dr Hegde has often stressed the focus on profits that drives the pharma and healthcare industries. Prof Dr Hegde has spoke about how billions of dollars are spent on AIDS and cancer research across the globe, that we are living in the era where diseases are sold. “All the crises modern medicine is facing is due to money. The lure for money has resulted in disease-mongering. 
 
It is clear that this is not an issue for only the American Healthcare market. Even in India the tug of war between patent holders, generics makers and drug-price controls has been on for a while. The recent mess of the (National Pharmaceutical Pricing Authority) NPPA decisions and subsequent U-turn shows that the Indian government too is struggling to find a balance between giving the companies a free hand and balancing it with the interests of the patients.
 
Coming back to the CBS report, it shows that for medication that goes into hundreds of thousands of dollars (in the Indian context similar Cancer medication costs lakhs of rupees), the patients and their families end up having to expend life savings, investments and inheritances for the future generations. The report cites cases where patients have had to unilaterally reduce their dosages to save on expenses. It might seem that turning over the healthcare system to the private sector's invisible hand has severe consequences for the well-being of the patients.
 
As Dr. Sadanand Nadkarni, a conscientious doctor and former Dean of Sion Hospital, writes “Though George Bernard Shaw warned society a hundred years back, the people have steadfastly refused to accept that the (private) healthcare sector is an INDUSTRY—a highly profitable industry because of extremely low consumer resistance. Worse, now it sells attractive healthcare ‘products’ at profitable rates. Profit gets priority and healthcare becomes a subsequent objective. Hence, actual “health service” becomes a by-product and the proportion of its availability depending on the moral concepts of individual doctors.”

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COMMENTS

TIHARwale

3 years ago

Since economics is an integral part of healthcare it will fitness of things to remember, way back in 1929 George Merck, President of Merck & Co had said “We never even for a moment try to forget that Medicine is for the benefit of the sick and needy. Definitely not for profit, profits follow. These words of George Merck should be a clarion call to pharmaceutical industry of their responsibility towards non wealthy patients and should be the coordinates of the principles of corporate policy.

Ankur Bhatnagar

3 years ago

The article shows multiple issues in healthcare. While the particular issue of pricing the patented innovations doesn't seem to have a clear solution, the other issues do have solutions.

Incentivising the doctors is clearly a wrong practice. It must be made illegal. I remember there was a rule that the doctors must prescribe only the 'salt' and not the brand to patients.

Then there is a big issue about the lack of credible information to public. There should be a neutral website operated by the government that gives clear information about the pros and cons and comparisons between the medicines. If a new medicines is priced twice over the existing medicine, the patients should at least get a chance to read the authoritatively correct information about the medicines before making up his mind to pay more.

Then you have the issues of fake medicines. Those issues too need to be tackled.

Finally, the problem boils down to the natural disbalance of information between a naive patient and a well trained but possibly corrupt doctor. The fair market mechanism to deal with this is to get insurance companies involved. They have a stake in and ability to commit resources for fighting overpriced healthcare. The insurance companies should be able to rate the doctors, drugs and hospitals who are needlessly expensive.

REPLY

Narendra Doshi

In Reply to Ankur Bhatnagar 3 years ago

Dear Ankur,
Some help is available on http://medguideindia.com/index.php
Do refer.

Ankur Bhatnagar

In Reply to Narendra Doshi 3 years ago

Thanks for the link! That's very useful. Is it your project?

Narendra Doshi

In Reply to Ankur Bhatnagar 3 years ago

NO, not my project.Learnt about a year ago. My doctors also approve it.

Narendra Doshi

3 years ago

Well summarized MDT

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