The Spokesman-Review’s “Area’s top-paid doctors” (April 10) missed the important point that all of the physicians in the top five practice in sub-specialties that require the use of very expensive physician-administered pharmaceuticals. The quoted numbers include a large pass-through to the drug companies.
In office practice, sub-specialists within ophthalmology inject medications into the eye that cost $2,000 per dose. Why so expensive? The drug companies only supported passage of health care legislation in exchange for dropping the call to give Medicare drug price negotiating power. In contrast, physician payment has been stipulated and negotiated on a per-procedure basis for more than 20 years.
In ophthalmology, the diseases treated with these drugs are common, wet macular degeneration and diabetic retinopathy, for example, and the medicines, Lucentis and Eylea, while nearly miraculous in effect, are suppressive, not curative. They must be injected repeatedly, often on a monthly basis, for years. The pass-through to Big Pharma runs millions of dollars annually in large medical practices.
The story is similar in rheumatology and oncology.
There were many caveats in your article, but nothing that addressed the specific “Why?” of your sensationalist list. Here is the why.
Jerry LeClaire, M.D.