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Prescriber Checkup Q&A

ProPublica reporters explain the data behind Prescriber Checkup, the first database to reveal what medications doctors and other providers are giving patients under Medicare’s Part D prescription drug program.

For the first time, ProPublica’s Prescriber Checkup reveals what medications doctors and other providers are giving patients under Medicare’s Part D prescription drug program. Patients can search the database to find their own doctors (or other doctors) and the drugs they order most often.

We asked the reporters behind the project – Charles Ornstein, Tracy Weber and Jennifer LaFleur – to explain the project and why it matters for patients.

Q. So, what’s in Prescriber Checkup?

A. You can search for doctors and other health providers who are active in Medicare’s drug program, called Part D. You can find out how many prescriptions each wrote and which drugs were prescribed. You can compare your doctor to others in his or her specialty and state. And you can check out the drugs you are taking or any that your doctor recommends.

 

Q. What did you find out about prescribers?

A. We found hundreds of doctors and others who prescribed large quantities of drugs that are potentially harmful, disorienting or addictive. One was a Miami psychiatrist who’s given hundreds of elderly dementia patients the same antipsychotic, despite "black box" warnings that it increases the risk of death. An Oklahoma psychiatrist regularly gave the Alzheimer's drug Namenda to autism patients even though experts said there is little evidence that it helps. We also found widespread prescribing of drugs like the muscle relaxant carisoprodol (a.k.a. Soma), which was pulled from Europe in 2007.

 

Q. Why does it matter if a doctor prescribes different drugs than his or her peers?

A. Every practice is different. Some doctors treat more seniors and disabled patients than their peers, so naturally their prescribing would be different. But sometimes differences might mean that a doctor is practicing in a way that is risky or not supported by medical evidence. Bottom line: If your doctor tends to prescribe drugs that others don’t it might be worth asking about. You want to make sure the drugs your doctor recommends are right for you and your condition.

 

Q. What can patients do with this information?

A. You can ask questions. What experience does your doctor have with the drug you have been prescribed? Why are his or her drug choices different from others in the same specialty? Is there a cheaper drug or nonmedical alternative that may be right for you? These are good questions in many circumstances, but they are particularly important if your physician stands out among peers.

 

Q. What can and should be done?

A. We outlined eight ways Medicare could do a better job overseeing its drug program – things like analyzing its own data, comparing prescriptions with diagnoses to be sure they make sense and taking action against physicians who’ve been indicted or arrested on prescription drug charges.

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