New medical guidelines require doctors consider the cost of treatments as well as their value says the NY Times
New medical guidelines are now being developed from a number of medical specialty groups to help combat the cost of medical care. Many of those treatments involve drugs that are new a wildly priced, with often little improvement over much less costly treatments.
This is a new development since doctors have always placed patients first and costs secondary, however, as patients are finding more and more of the cost shifted to them from insurance carriers, it places sometimes unrealistic financial burdens on those you are trying to help.
The good news (or bad depending on your point of view) is that doctors may begin to ask themselves if tests are really necessary as well as a particular drug. Since cost does not mean that the quality of the treatment is better or worse, two medications that offer roughly the same benefit, with a newer one being marginally better at something, may not be worth paying 50 times the price. Also, medical testing most often comes back with negative outcome, so advising a patient that this test will most likely not be helpful is actually good medical advice, especially as more insurance policies come with larger deductibles that the patient pays. This is especially true in our office when we consider when we should or should not order an MRI since the test may not change the course of treatment, and therefore is of limited value diagnostically.
Is this rationing? Perhaps, however, it may also force drug companies who want to sell their expensive products to rethink their pricing of brand name miracle cures, since it will not sell if it is not priced appropriately, similarly to anything else in the marketplace. Since drugs are generally designed to treat a symptom or a chemical mechanism and not be a cure in most cases (although it sometimes does cure problems such as Aids and AZT in young children), having market forces and the guidance from doctors who now consider cost can only be a good thing for the American public. Wow, economics in healthcare; not such a bad idea.
Check out the article here
Cost of Treatment May Influence Doctors
Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.
The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.
“We understand that we doctors should be and are stewards of the larger society as well as of the patient in our examination room,” said Dr. Lowell E. Schnipper, the chairman of a task force on value in cancer care at the American Society of Clinical Oncology.
In practical terms, new guidelines being developed by the medical groups could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment — at the end of life, for example — is too expensive. In the extreme, some critics have said that making treatment decisions based on cost is a form of rationing.