ProPublica, a nonprofit news organization, recently launched a database on physician prescribing habits. Searchable by provider name, state and city, the database compares a physicians' name-brand vs. generic prescription rates, and calls out providers who prescribe name brands at higher-than-average rates.
The database draws on Medicare Part D prescription data from 2011, which ProPublica obtained through a Freedom of Information Act request, and includes all providers who wrote at least 50 prescriptions for at least one drug that year.
On average, providers nationally prescribe brand-name medications for 21.21 percent of prescriptions. Many outliers, both geographically and by provider, exist. For example, in New Jersey, the state with the highest rate of name brand prescriptions, the average is 28 percent. In Minnesota and Nevada, it's just 17 percent.
The data is fascinating, and the database even allows searching by institution. Here in Chicago, 22 percent of Rush University Medical Center's prescriptions are name-brand, and the rate for University of Chicago Medical Center is nearly the same at 21 percent. Northwestern Memorial is just slightly higher at 23 percent.
Why do generic prescription rates matter?
Generic prescriptions cost less than name brand drugs, and for federally funded health programs that are desperately looking for ways to save money, generics help bring down healthcare costs without sacrificing quality. Medicare's Value-Based Purchasing efforts haven't yet targeted physicians, or the cost of care, but many expect such a system of reimbursement isn't so far off.
Physicians who don't consider generic alternatives face scrutiny today and potential reimbursement decreases in the future.
Interestingly, ProPublica found that even a relatively small number of physicians can drive significant Medicare costs. Of the 1.6 million providers in the database, just 913 physicians "cost taxpayers an extra $300 million in 2011 alone by disproportionately choosing name-brand drugs," according to a ProPublica report.
Unlike most commercial prescription coverage, where a patient pays more for a name-brand and therefore may ask a doctor for the generic, Part D charges a flat rate regardless of the drug's cost. So, while the name-brand isn't costing patients, it's certainly costing Medicare.
Take for example Plavix, which costs around $193 per prescription. Its generic, clopidogrel, has been available since 2012, and its cost can be half of the name-brand, or less.
Physicians and health systems should take note of the easy availability of this data. While we shouldn't expect most patients to be rushing to check out their provider's generic prescription rate, federal and state efforts to contain healthcare costs — as well as health systems' efforts to take on risk — could mean this data will mean a lot more to providers' pay and volumes in the years ahead.