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I'm skeptical for these ophthalmologists to be billing those numbers and NOT include the average sales price (ASP) of their injectable drugs. For those looking
by riahi 13y ago
I'm skeptical for these ophthalmologists to be billing those numbers and NOT include the average sales price (ASP) of their injectable drugs.
For those looking in, ASP is how medicare reimburses outpatient drugs. The physician practice buys the drugs up front, then bills Medicare the "average sales price" + 6%. The issue at hand is that Lucentis runs $2120 per injection. If you have a decent or large sized macular degeneration patient population, you'll be doing a lot of these injections. However, the number the practice collects is $320. Out of that number, you have to pay overhead / office staff / supplies etc.
- refurb 13y agoI just downloaded one of the excel sheets and I only see procedures on the list, no drugs, but your suspicion is warranted. The other thing to remember is that if it did include ASP reimbursement, ophthalmologists wouldn't be at the top, oncologists would. If a cancer doc saw 200 HER2 positive breast cancer patients in one year (16/month), treating them with Herceptin alone would cost $14,000,000. Most docs I've spoken to see 100-200 cancer patients per month (of course not all get treated with expensive drugs).
- riahi 13y agoYes, but you have to remember that these are Medicare data. The prevalence of 65+ patients getting Her2+ breast cancer AND getting treatment with Herceptin is probably lower than the number of 65+ patients getting ARMD and going on treatment with Lucentis. Unfortunately, I don't have a good source. The above is merely my speculation.