Under the Freedom of Information
Act, ProPublica obtained data on the prescriptions written by more than 1.6
million providers in the Medicare Part D program in 2011.
Our analysis focused on the nearly
364,000 providers who wrote at least 50 prescriptions, including refills, for
one drug. For each provider, we calculated a name-brand dispensing rate, and
for comparison, we determined the overall rate for every medical specialty in
each state.
We identified as outliers providers
who were at least two standard deviations from the mean in their specialty and
state. These included about 11,750 who had name-brand prescribing rates that
were higher than their peers and 3,000 who had name-brand prescribing rates
that were lower.
To estimate the cost of high
name-brand prescribing, we looked at primary care doctors, who treat many
conditions for which generics are readily available. (We excluded doctors who
regularly use costly HIV/AIDS drugs for which there are few generics.)
We identified 913 primary care
doctors who wrote at least 5,000 prescriptions in 2011 as outliers. They
accounted for more than $1 billion in drug spending. If their average cost had
equaled that of their peers, Medicare would have saved more than $300 million
in 2011 alone.
Next, we matched these 913
prescribers against our Dollars
for Docs database of payments for speaking, consulting, research, meals and
gifts made by 15 pharmaceutical companies since 2009.
Results
showed that 48 percent of the prescribers with high rates of name brand use
received at least $1,000 from the companies, excluding research.
To compare, we selected a random
sample of 1,000 primary care doctors who were not disproportionate name-brand
users. Of those, only 15 percent received at least $1,000 in payments.
