Severe shortages for life-saving medications have driven a “gray market” in the wholesale drug supply industry, a watchdog group reports.
And the mark-up on gray market drugs is a budget-buster, reports the Institute for Safe Medication Practices, a Philadelphia-based nonprofit organization devoted entirely to medication error prevention and safe medication use. Purchasing agents and pharmacists at 549 hospitals responded to a survey on gray market activities associated with drug shortages.
The report includes chilling anecdotes from the respondents about pressure from physicians and administrators to ensure drugs are available, and drastic price gouging from the gray market suppliers. Price mark-ups of 10 times or more than the contract price were reported by about a third of respondents from critical access hospitals and community hospitals, and more than half of university hospitals. Examples include a box of calcium gluconate that cost $750 instead of the contract price of $50 (1,400% mark-up), and a supply of propofol that cost $25,000 instead of $1,500 (1,567% mark-up). Oh, and there’s exorbitant shipping and handling fees, too. Read more »
*This blog post was originally published at ACP Hospitalist*
The total debt cost of medical school has become obnoxious. When I started medical school 15 years ago this month, I took out approximately $2,000 a month in loans. $1,000 a month for all living expenses, including food, rent, utilities and entertainment and $1,000 a month for tuition and related expenses. I got out of medical school with just under $110,000 in loans for which I am currently paying back at a rate of $500 month for 30 years.
I learned the other day that a family medicine resident recently completed medical school with almost $250,000 in medical school loans. Family medicine? $250,000? Are you crazy? If that resident can lock in a 30 year loan at 3.5%, they’re looking at monthly payments of $1,200 a month for the rest of their lives. With current tax rates, this family resident will need to earn at least Read more »
*This blog post was originally published at The Happy Hospitalist*
You could see the frustration in his eyes as he spoke to his fellow resident.
“I had to fork over eight hundred and thirty five dollars,” he said slowly in a disgusted tone, “… and that doesn’t even include the $300 state license fee we have to pay later….”
So much for starting our EKG conference on time.
The comments continued. No one could understand why medical school licensure has become so expensive in the US. I thought I’d look into what medical students can expect to pay these days for licensure since it had been a while since I had gone through the gauntlet. Here’s what I found out: Read more »
*This blog post was originally published at Dr. Wes*
There has been a significant outcry against the proposed ACO regs: everything’s wrong and nothing’s right about them, or so some would have us believe. (The comment period is still open, and CMS is still soliciting input; much of the outcry is a form of posturing and negotiation … not that there’s anything wrong with that.)
Today’s “nattering nabobs of negativism” focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure incuded), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the premature pledging of allegiance to an idea only partly proven through the PGP demo, the likelihood of failure due to the whole endeavor’s being tied to FFS reimbursement, on the one hand, and due to exposure of ACOs to downside risk, on the other, the unreasonable reliance on dozens and dozens of quality measures . . . and the list goes on. For further detail, see, e.g., David Dranove’s recent post decrying unproven theories baked into the ACO program (with a link to info on the PGP demo’s results, and differing interpretations of those results; check out the lively discussion in the comments to Dranove’s post on The Health Care Blog), Jeff Goldsmith’s opposition to ACOs as conceived in the ACA (and alternative proposal discussed in the linked post), and Mark Browne’s search for a few good quality measures. (This has been a recurring theme for me as well; I would love to find six or eight meta-measures that predict all others; Mark links to the AHA’s comments on the ACO rule, which are worth a read). Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
Those who market heart scan services should be more careful about what they promote and to whom.
When ProPublica’s Marshall Allen got a telemarketing offer for heart scans for him and his wife, he followed up with a story, “Body Imaging Business Pushes Scans Many Don’t Need – Including Me.”
Reminding Allen about the deaths of figure skater Sergei Grinkov, baseball player Darryl Kile, newsman Tim Russert and actor Patrick Swayze, the salesman said:
“You never know when it could happen. … Boom, you’re dead!” he exclaimed, slapping a desk for emphasis.
But Allen tells another story – of complaints by patients and regulators about the business. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*