Inappropriate Care Costs U.S. $6.76 Billion Annually
A new study almost $7 billion of wasteful spending in American health care:
- $5.8 billion: Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first.
- $527.4 million: Bone density scans for women ages 40 to 64 years.
- $175.4 million: Ordering CT Scans or MRI’s for lower back pain.
- $116.3 million: Prescribing antibiotics to children with sore throats caused by a virus.
- $47 million: Pap tests for patients younger than 21 years of age.
Read the whole report at the Archives of Internal Medicine.
To my knowledge there are no complaints about the high cost of inappropriate car purchases, wasteful restaurant menu selections, or needless Redskins tickets. Yet billions are wasted on each of these each year.
The difference, I suppose, is that individuals aren’t paying for their own health care, so the cost is socialized.
It is interesting how these are categorized as waste. Doctors and drug companies probably consider these things income.
I’m sort of impressed with the difference in the wasted amounts. $5.8 billion for expensive statins, but only $47 million for pap smears. It shows you just how expensive it is to care for an aging population.
From what I’ve heard, getting old is expensive!
As one would expect, the “study” alleging waste in statin use took survey results from the National Ambulatory Care Survey. “Non-recommended care” was defined by the Good Stewardship Working Group. Then name along is cause for concern.
Inappropriate actions were prescribing atorvastatin or rosuvastatin–Crestor and Lipitor, respectively. There have been clinical reports suggesting that both of them do a better job of lowering LDL-C in clinical studies than some of the generics. It might, therefore, make perfect sense to prescribe them in some cases. Given that they were prescribed in 35% of the cases in the sample, who knows if it was inappropriate or indicated. The “study” contains no information about a given patient’s circumstance.
Maybe if there had been a little more effort to give information on treatment goals relative to patient lipid levels this “study” claiming waste would be more believeable. Instead, the reference says that work groups of physician panels developed the Good Stewardship guidelines in several rounds. The first field testing involved all of 83 primary care physicians.
There is no information on how these “Good Stewards” were selected. I’m betting it wasn’t random.
Snowballing off Linda Gorman:
Four physicians cast judgment on the appropriateness of care delivered by tens or perhaps hundreds of thousands of physicians on millions of patients. The four physicians who wrote the article did not see one single patient in question.
I can imagine what the editors of a journal of civil engineering, for example, would do if they received a paper from four civil engineers purporting to cast similar judgment on the “appropriateness” of every bridge constructed during a given period, without having actually inspected even one of the bridges!
Plus, let’s put this into perspective. Total U.S. health spending in 2009 was $1.5 trillion. So, if “inappropriate” spending was $7 billion, that’s less than three percent. Pretty darned good, I’d say.