Why American doctors keep doing expensive procedures that don’t work

[Free Vulcan]

The recent news that stents inserted in patients with heart disease to keep arteries open work no better than a placebo ought to be shocking. Each year, hundreds of thousands of American patients receive stents for the relief of chest pain, and the cost of the procedure ranges from $11,000 to $41,000 in US hospitals.

But in fact, American doctors routinely prescribe medical treatments that are not based on sound science.

The stent controversy serves as a reminder that the United States struggles when it comes to winnowing evidence-based treatments from the ineffective chaff. As surgeon and health care researcher Atul Gawande observes, “Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm.”

Read more at: https://www.vox.com/the-big-idea/2017/12/28/16823266/medical-treatments-evidence-based-expensive-cost-stents

[Applewood]

Seems to me it's insurance that dictates what is prescribed.  When it was discovered that I had an irregular heartbeat, first thing I asked was, am I going to need a pacemaker?  No. the doctor said, we will try to control it with medication first.   Well, the medication didn't help.  Then I had an assistive device implanted.  It appears that insurance either encourages or mandates that this least invasive -- and least expensive -- treatment is tried first.  If that doesn't work, then go for the more expensive. 

Same with my diabetes meds.  I was taking one drug that did a good job, but then the formulary used by insurance companies changed and that drug was given a higher tier -- which meant a higher copay.  Doctor switched me to a cheaper drug that didn't work well at all.  I had to fight tooth and nail to get back on the more expensive drug.  Doctor kept going on about the higher copay, but I told him I'll pay more for a drug that works.

Maybe it's because my insurance is a Medicare supplement, but I'm not getting the most expensive drugs or procedures.  After all, we old folks are going to die anyway.  If the cheaper med or treatment doesn't work and the patient croaks, who cares?

[dfwgator]

$$$$$$$$$$$$$$$$$$$

[To-Whose-Benefit?]

Drug and Device makers directly pay over 1/3 of FDA's annual budget.

https://www.fda.gov/ForIndustry/UserFees/PrescriptionDrugUserFee/ucm152775.htm

FDA is just working for its top customers.

The AMA has been derided for decades as nothing more than a Surgeons Union.

And State Medical Boards entrusted with disciplining out of line and crooked Doctors are Run by Doctors running cover for their colleagues.

And the beat Goes Onnnnnnnnn. And the beat goes onn, nnnnn.