At One Brooklyn Address, $1.8 Million Wasted

Tuesday, November 19, 2013

The Levit Medical Arts Pavilion on Avenue P in Brooklyn (Amanda Aronczyk)

Medicare Part D, which provides medications to 36 million Americans by giving seniors and the disabled access to prescription drugs, is often described as a healthcare success story, coming in below cost estimates.

But when ProPublica looked closely at Medicare's prescription data, they found hundreds of millions of dollars a year were being wasted — all because a small percentage of doctors prescribe name-brand drugs instead of lower-cost generics, even when the generics work just as well. Right here in New York City, these doctors could save Medicare over $50 million a year.

WNYC teamed up with ProPublica to find out: why? We started by visiting 1220 Avenue P in Brooklyn, the Levit Medical Center. If just six doctors at this one address prescribed in a different way, they could have saved Medicare $1.8 million dollars in 2011 alone.

Want to find out how your doctor is prescribing? Check out ProPublica's Prescriber Checkup. Type in a physician's name or zip code and you'll find out more about how physicians spend Medicare's money.


Versions of this story were co-published with public radio station WNYC in New York, with American Public Media’s Marketplace and with Digital First Media web sites and newspapers.


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Comments [17]

Jon from Connecticut

This story reeked of arrogance on so many levels. What bothered me most about this story was not the fact they based the whole story on the presumption that generic and brand-name drugs are absolutely equivalent. That is just not true in all cases, but surely they are the same in most. More outrageous was the assertion that doctor's are responsible for curbing government expenditures. The story verges on a witch hunt (especially given the web tool) against doctor's who prescribe an above average level of brand name drugs. Doctor's serve their patients, they do not serve the US government. If the goal of the government is reduce brand name drug usage, they should increase the copay differential for these drugs.

Surely, one may think that others are making a silly choice by insisting on brand names. Surely, marketing causes seemingly uneconomic choices, but that is why people have a choice. Make the patient offset the increased cost of buying a brand name drug. If they still want it. That is their choice.

Nov. 20 2013 02:37 PM
undisclosed from NYC

Whatever merits the rest of the story may have, Nexium is the wrong example to illustrate it. The story states that Nexium has a generic equivalent. This is not true. Although there are other drugs of the same class--proton pump inhibitors--including over the counter omeprazole (AKA Prilosec), they are not the same thing.

How do I know? I have been on Nexium for many years. Recently, I ran out and used omeprazole for a brief period. The pain in my gut while on omeprezole told me that the drugs are not equivalent. My doctor agrees and has since helped me resume Nexium.

Illustrating a story with erroneous 'facts' cast doubts on the rest of the story and calls all of WNYC's journalism into question. A correction is in order.

Nov. 20 2013 02:12 PM
aw hess from LINY

and generics are not legally liable as original patent holders are. The system needs reform.

Nov. 20 2013 08:14 AM
Michael D from NYC

My dermatologist always tries to prescribe non-generic medication, and I have to remember to ask him for generic. In his case he's a shill for the pharmaceutical companies. They send him around the country speaking about their products.

Nov. 20 2013 08:13 AM
Gaffney from Bronxville

This report is slighted in the notion that only disenfranchised communities are ignorant to the
cost-effectiveness of using generic brand prescriptions. Instead of exhibiting a piece on
"you poor people and poor people's doctors are wasting our government handouts",
the reporting should be on WHY generic and brand name medications are grotesquely
disproportioned. Give all individuals credit for weighing cost and medication effectiveness
on both sides of economic divide. Even the financially stable enjoy cost benefits…
if the results are worthwhile.

Nov. 19 2013 11:51 PM
person sensitive to certain generics from New York, NY

Wanted to add my own experience with certain generics vs. brand name medications - there appears to be a quality control issue with generic medications when compared to brands, the fillers used, and additionally I have noticed differences from one batch to another. However I do know of individuals who are fine taking generics and undeniably there is an advantage both on the personal and social scale with regards to cost. I have also noticed that there is a big difference from one generic to another on the exact same medication.

I am curious to know what the guidelines are on the manufacturers of generics.

Nov. 19 2013 10:30 PM
Kate from NY

I am hoping I heard this wrong-- but I could swear the reporter said the 65 year old female patient who insisted on brand name drugs just came to the US from Russia 5 years ago?

Is that possible? How on earth could she be eligible for Medicare, having been in the US for only 5 years?

No wonder Medicare and Social Security are going broke!

Nov. 19 2013 08:04 PM
Eileen McInerney from North Caldwell

I did not hear this entire segment but wish to comment on the difference between generic and brand name drugs, as I see many others have. I have been told by people in the pharmaceutical industry (one a pharmacist for 40 years and the other was involved in writing up the study protocols), that there can be a difference. As I recall, the generic can vary from the brand name in bioavailability by 10% in either direction. And it never has to be tested again once it has been approved. I am chronically on medications, and I take generics when they are available except for Synthroid as per my endocrinologist. A 10% difference either way is too great for that medication. I was on Arimidex for 5 years, and a generic aromatase inhibitor came out ~ 3 1/2 years after I began that therapy. I didn't want to take a chance on an anti-cancer medication, especially after speaking to my friend in the industry who informed me of the differences in active medication available in the bloodstream. I'm sure there's some fraud and laziness, but to recommend only generics all the time may be bad medicine.

Nov. 19 2013 06:13 PM
Leonore from Brooklyn

I agree with many of those who posted responses. I have Parkinsons, and generic drugs are very inconsistently effective in treating our disease, and the many additional symptoms we have. My doctors prescribe generic drugs for a few of my symptoms, but some of my most effective med's don't have generic options. The pharmaceutical industry is the robber baron in this story, and who we should all be indicting!

Nov. 19 2013 06:10 PM
Kelly Carter from Georgia, USA

My son, now 22, has had terrible seizures since birth. On several occasions we found that seizures increased after switching from brand name drugs to generics. We begged to switch back, even if it cost more, and it always did. Could we PROVE that it was the generics? No. Would YOU experiment with your child, and risk agony, to PROVE it BEYOND DOUBT? No, you wouldn't. You would ask or even beg for brand name drugs.

Nov. 19 2013 06:01 PM
Fran@11229 from Brooklyn

This story is not about the pros and cons of generics. The owner of this medical facility also owns the on-site retail pharmacy. The small numbers of generics prescribed may indicate a facility policy of prescribing more expensive brand drugs, which are then filled for a higher profit at the on-site drug store. Given that many patients of this facility have Medicare D or Medicaid, we are all paying for this scam.

Nov. 19 2013 04:20 PM
BrklynBeeGee from Brooklyn

Generics can not be successfully used instead of brand names in all cases. I am an example. I take an drug to prevent high cholesterol. Originally my doctor tried me on a few generics, but I suffered from painful side effects. I now take a brand name drug, and have no side effects. So when in this story they just state that generics SHOULD be used instead of brand names for everyone I have to disagree. What I do agree with is that doctors should try out the generics with their patients whenever possible without harmful side effects, but the use of generics should not be dictated by consideration solely of cost. I think it reasonable that be a protocol that generics be tried first, but if the patient does not react well to the generic drug then a brand name can be used.

Nov. 19 2013 12:13 PM
Ebeth from Montclair

Generic drugs are NOT always the same as the brand and sometimes do have disastrous results. Ignoring these facts was a serious error in this report.
The inspection issues were already addressed above, but also having the same "active ingredients" does not address other ingredients that are present or absent in the brand vs. generic which in many cases completely change the drugs effectiveness in individual metabolism.
My son takes Ritalin daily which makes his successful happy life at 10 possible. When we have taken the generic for several days to "save money" and then later without realizing the pharmacy had substituted the generic, he couldn't function in school, could not concentrate or follow directions, and even became belligerent with his teacher in third grade which he'd never done. Switching back to the brand solved the problem instantly. Leaving out the fact of the failure of generics, in this report is irresponsible and perpetuates serious issues for those of us dealing with insurance companies ever changing policies on coverage.

Nov. 19 2013 12:03 PM
ronald Brandt from NJ

In many cases generic drugs are NOT the same as the branded variety. There is such a push to lower costs, that effectiveness is often disregarded. it is only a few years ago that the FDA started to tighten the regulations on generic drugs. There are still many gaps. I for one, would never take a generic drug produced by any company in India or China. The inspection protocols are very weak in those countries, and abuses are found every year.

The newer Biologic drugs are even more complicated, there is no way that a generic can be identical. The FDA simply hopes for bioequivalent.

Nov. 19 2013 11:17 AM
Dave K from Manhattan

Whatever the accuracies of this article, 18 million is hardly representative of how brutally cruelly commercial America's medical system is.
There's is little to register but disgust for the sheer number of pigs at the trough.
They take kick backs for prescribing non- generics. Surprised?
The 'good' news? :
This will only continue until the reprobates who lobby for big pharma in washington succeed in getting all these white collar hostage takers permanent rights for manufacture and distribution whatever garbage they make.

Nov. 19 2013 10:15 AM

Dig a little to find out why generics are so much less expensive than brand (even than brand as sold in countries with lower prices across the board). There are differences. Not saying that the patients convinced that "more expensive means better" are right, but they can't be quite so easily dismissed.

Nov. 19 2013 08:32 AM
Ruben RPh from NY

This news peice is so full of misinformation it needs to be revoked.


And that is just the primary error in the report.

Other errors:
A) The Government doesn't pay list prices for drugs
B) Insurance companies that administer medicare part D want even allow cheap drugs any longer without P/A
C) The cost of the drugs is graft on the part of the insurers, and the whole pricing scheme is a price fixing scheme.
D) $8,000 a year is outragous for drugs? Really? And 15K is reasonable to deliver a baby?

This is bs canned news of the worst kind

Nov. 19 2013 06:35 AM

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