Enhanced Reimbursement Incentives for Generic Cancer Drugs Found Not to Affect Prescribing Patterns

“As with other studies,² this study actually once again debunks the unfounded assertion that oncologists prescribe cancer therapy based on financial incentives,” said Okon. “UnitedHealthcare already knows this, with its landmark episode-of-care study that clearly proved when any so-called prescribing incentives are removed, that drug spending actually increased. Oncologists, in collaboration with their patients, base cancer therapy decisions on what is the best course of treatment.”

Okon added that he found the timing of the release of the study quite striking, as this study is released around the same time that UnitedHealthcare is slated to release a step-therapy mandate requiring the use of the more-expensive Neulasta (pegfilgrastim) before the less-expensive biosimilar. Remarked Okon, “Ironically, UnitedHealthcare is motivated to force oncologists to use the most profitable drug for the insurer, rather than the less-expensive biosimilar.”

References

1. Yasaitis L, Gupta A, Newcomb C, Kim E, Newcomer L, and Bekelman J. An insurer’s program to incentivize generic oncology drugs did not alter treatment patterns or spending on care. Health Aff (Millwood). 2019;38(5):812-819.
2. Community Oncology Alliance. The myth of perverse physician incentives: examining research and accusations in the Medicare Part B ASP reimbursement system for oncology. Published December 31, 2018. Accessed May 6, 2019.

This article originally appeared on Cancer Therapy Advisor