UnitedHealth Group Inc., the biggest U.S. health insurer by sales, will pay cancer doctors to stop marking up the prices of drugs, in a test aimed at reducing costs for medical plans and their customers.
Physicians serving 1,500 cancer patients in Georgia, Missouri, Ohio, Tennessee and Texas will receive reimbursement for the wholesale cost of medicine they administer, plus a fee that will stay the same regardless of the drugs involved, UnitedHealth said today in a statement.
That will erase an economic incentive for doctors to prescribe more-costly drugs, as physicians now buy the medicines from drugmakers and charge as much as 30 percent more when submitting claims to insurers, said Lee Newcomer, UnitedHealth’s senior vice president for oncology for UnitedHealth, based in Minnetonka, Minnesota. Cancer drugs account for 60 percent of income for oncologists, Newcomer said.
“If they are using expensive drugs, that’s OK -- we’re going to reimburse for the cost of that,” Newcomer said. “But they’re not going to make any more or less profit off of it, and we’re not going to pay inflated prices for a drug.”
Newcomer said it’s unclear how much money the experimental system may save UnitedHealth. Its commercial insurance unit, UnitedHealthcare, spent $1.1 billion on injectible chemotherapy drugs in 2009, about a quarter of the company’s cancer-care spending, he said.
UnitedHealth Alters Pay Rules on Cancer Treatments - Bloomberg
via bloomberg.com
