Drugmaker pushes new drug over cheaper equivalent at Medicare's expense

Dec 9 2013

The Washington Post explores the public impact of doctors' decisions to choose a more expensive drug to prevent blindness despite trials showing the drug is equivalent to a much cheaper product. Other media report the federal court decision in Connecticut that temporarily blocks UnitedHealthcare from terminating more than 2,000 doctors from its Medicare Advantage network in that state.

The Washington Post: An Effective Eye Drug Is Available For $50. But Many Doctors Choose a $2,000 Alternative.
The two drugs have been declared equivalently miraculous. Tested side by side in six major trials, both prevent blindness in a common old-age affliction. Biologically, they are cousins. They're even made by the same company. Avastin costs about $50 per injection. Lucentis costs about $2,000 per injection. Doctors choose the more expensive drug more than half a million times every year, a choice that costs the Medicare program, the largest single customer, an extra $1 billion or more annually (Whoriskey and Keating, 12/7).

Kaiser Health News: Judge's Medicare Advantage Order Could Have National Impact
In a decision that could have national implications, a federal judge in Connecticut temporarily blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state. While the judge's decision affects only the physicians in Fairfield and Hartford Counties who brought suit, several other medical groups are considering filing similar actions (Jaffe, 12/6).

The CT Mirror: Judge Blocks UnitedHealthcare Medicare Advantage Doctor Cuts
A federal judge has temporarily blocked UnitedHealthcare's move to terminate Connecticut physicians from its Medicare Advantage network. U.S. District Judge Stefan R. Underhill granted a preliminary injunction requested by the Fairfield County Medical Association and the Hartford County Medical Association. The two medical groups took legal action after UnitedHealthcare notified about 2,200 doctors that they would be dropped from its Medicare Advantage network as of Feb. 1 (Becker, 12/6).