$6.7 billion spent unnecessarily on health care in 2009

Kathleen Blanchard's picture
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In a letter published in the October 1 Online First issue of Archives of Internal Medicine, researchers report $6.7 billion was spent in unnecessary health treatments and tests in 2009.

86 percent of excess healthcare spending from brand name statins

The authors found 86 percent of the spending came from primary care physicians who prescribed brand name anti-cholesterol drugs, despite the fact that generics are just as effective.

For the study, a Mount Sinai School of Medicine team of investigators looked at the most overused clinical activities performed by pediatric, internal medicine, and family medicine primary care specialties.

Minal Kale, MD, a postdoctoral fellow in the Division of Internal Medicine in the Department of Medicine at Mount Sinai School of Medicine headed the study that came from a review of a published study in the May 2011 issue of Archives of Internal Medicine.

The researchers then analyzed data extracted from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, finding the excess $6.7 billion spent on unnecessary blood work, scans, antibiotic prescriptions and brand name statin drugs.

Blood work, tests, x-rays ordered by doctors, but not needed

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In a breakdown of costs, the investigation found $32 million in excess costs from unnecessary blood work, $527 million from primary care physicians ordering bone density tests in younger women and $175 million in excess healthcare costs from MRI’s and X-rays for complaints of back pain.

The researchers also found excess spending for antibiotic prescribing for other than strep throat or fever in children, accounting for $116 million in unnecessary costs.

More than $5.8 billion was spent prescribing brand name statin drugs – accounting for ”astronomical” costs that Dr. Kale says could be replaced by effective generic medications.

Efforts to encourage prescribing of generics clearly have not gone far enough,” said Dr. Kale. “Additionally, millions are spent on unnecessary blood work, scans, and antibiotic prescriptions. Significant efforts to reduce this spending are required in order to stem these exorbitant activities.”

Kale says with so much debate on healthcare reform, it’s important to examine how the "Top Five" non recommended practices from primary care physicians contributes to health care spending.

"Research might focus on the potential role of reimbursement, defensive medicine practices, or lack of adherence to guidelines."

The authors say physicians should evaluate how they can cut costs related to treatments and medications, and make reductions where they’re needed.

“We found considerable variability in the frequency of inappropriate care, however our data show that even activities with small individual costs can contribute substantially to overall healthcare costs,” said Dr. Kale. The study found $6.7 billion was spent on healthcare in 2009 from overprescribing of drugs like antibiotics, unnecessary tests and prescribing anti-cholesterol drugs known as statins, when effective generics are readily available.

Archives of Internal Medicine
"Top 5" Lists Top $5 Billion
doi:10.1001/archinternmed.2011.501
October 1, 2011

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