The Centers for Medicare & Medicaid Services recently made available to the public for the first time detailed data from 2012 regarding the Medicare Part B program: More than 9 million records of data for more than 880,000 healthcare providers including the services provided, the drugs administered, and the amounts paid for those services and drugs by the Medicare Part B program. As a result of the data release, high-billing doctors, particularly ophthalmologists, have received considerable scrutiny by the press.
The authors examine two competing hypotheses regarding ophthalmologists’ use of the drugs Lucentis and Avastin. In particular:
- Do ophthalmologists that administer Lucentis do so because they earn higher profits, as has been suggested in the press?
- Do ophthalmologists exercise medical judgment on a patient-by-patient basis and administer Lucentis because it is the best choice in certain instances?
The paper was featured in the November 12 PharmExec article titled "Medicare Part B Data: Approach with Care."