Examining Financial Incentives For Physicians

Armen Hareyan's picture
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The Wall StreetJournal on Thursday examined how some health insurers are "drawingscrutiny for offering financial incentives" as part of efforts toencourage physicians to switch patients from brand-name medications toless-expensive, generic treatments.

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According to the Journal, although large pharmaceutical companies"have long gone to great lengths" and have invested "billions ofdollars plying physicians with samples, educational lunches and speakerfees" to promote their products, health insurers are "trying to trumpthose perks" with monetary gifts and higher reimbursements. Healthinsurers maintain that increased use of generic medications will reduce costsfor patients, employers and health care providers, and many physicians"argue that it's only right to reimburse them" for the time requiredto determine whether less-expensive, generic medications are "better or asgood" for patients than brand-name treatments, the Journalreports.

However, lawmakers and patient advocacy groups have raised concerns that"injecting financial incentives into what ... should be a purely medicaldecision" could affect quality of care, and medical societies maintainthat the practice places physicians in the "ethically questionableposition of taking a payment that patients know nothing about," accordingto the Journal. In response to concerns about the practice, the American Medical Association recently published an onlineadvisory titled "Kickback Questions and Answers." According to theadvisory, "Accepting payment for moving a patient from a brand name to ageneric could be viewed as an anti-kickback statute violation" (Fuhrmans, WallStreet Journal, 1/24).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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