Suffer from iron deficiency anemia?
Your health care provider might suggest Injectafer or another infusion drug to treat your iron-poor blood, whether you need it or not.
These pricey medications have become all the rage in recent years. But a new report from Kaiser Health News suggests financial incentives, rather than patient need, is actually fueling their current popularity.
Treatments for iron deficiency anemia have been around for over a century.
Geritol, one of the most ubiquitous, was launched in the 1950s and can still be purchased over-the-counter for less than $10.00.
Intravenous iron was introduced in the early 2000s. While these drugs are only indicated for patients who don’t responded well to dietary changes or oral supplements, Kaiser Health News found that nearly one in five Medicare patients has received IV iron since 2013.
Injectafer and Feraheme — the two newest (and most expansive) infusions on the American market — accounted for more than half of intravenous iron infusions in 2017, up from less than a third in 2014.
Overseas, however, doctors are much less likely to resort to intravenous iron, especially when patients have no underlying disease or obvious symptoms of anemia.
So why the discrepancy? Apparently, the current pricing structure in the United States has created a huge financial incentive that might be driving many doctors, hospitals, and clinics to push Injectafer and Feraheme on their patients, even when less pricey and equally effective treatments are available.
Under Medicare, for example, a doctor’s payment is partly based on the average sales price of the prescribed drug. Private insurance allows for an even bigger mark-up. And because Injectafer and Feraheme are generally administered in a hospital or clinic, they also generate a “facility fee.”
“When there’s a financial incentive … that might move the physician away from the choice the patient would optimally make, we might be concerned,” says Aditi Sen, a health economist at Johns Hopkins Bloomberg School of Public Health, told Kaiser Health News
The example of iron infusions, she added, suggests “a clear financial incentive to prescribe more expensive drugs.”