DaVita Wasted Drugs To Make Big $$ Off Medicare
8 CommentsBy Ed Silverman // July 26th, 2011 // 7:31 am
One of the biggest providers of kidney dialysis deliberately wasted medicine in order to gain hundreds of millions of dollars in extra payments from Medicare, according to a whistleblower lawsuit filed by a former clinic nurse and doctor. They claim DaVita used unnecessarily large vials of different meds because Medicare would pay for unused portions of each vial if these were deemed unavoidable waste, The New York Times writes. DaVita denies the accusations.
The charges, the paper notes, underscore how financial incentives may have prompted overuse of drugs in the dialysis business, which DaVita dominates. In January, though, Medicare changed payment systems and now pays for overall treatment and instead of paying separately for drugs, the Times writes, adding that clinics could make a profit because Medicare would reimburse at levels higher than what clinics paid to buy the drugs.
As an example: instead of giving an entire 100-milligram vial of the Venofer iron drug once or twice a month, DaVita clinics gave 25-milligram doses more frequently, according to the lawsuit. But since the drug came only in a 100-milligram vial, Medicare was billed for 100 milligrams for each dose, even though 75 milligrams were wasted (here is the lawsuit).
Daniel Coyne, a nephrologist at Washington University School of Medicine who treats some patients at DaVita clinics, tells the Times it was “absolutely true” the iron drug was given in small increments to make more money. “How could it possibly be that patients in DaVita facilities were getting so much more iron than patients in other facilities and not getting iron overload?” he tells the paper. “The answer is the iron wasn’t going into them. It was being thrown away to make a profit.”
The feds investigated the claims, but declined last April to join the lawsuit, which was first filed in 2007 and was more recently unsealed. Bill Myers, a DaVita spokesman, tells the Times that the decisions by the feds not to pursue the lawsuit suggested the accusations were weak, and that Medicare had approved the dosing plans, although he could not provide proof until presented in court.
One of the men who filed the lawsuit was Daniel Barbir, a nurse who worked from 2000 to 2006 as director of a dialysis clinic in Cumming, Ga., that was owned by Gambro, a dialysis chain acquired by DaVita in 2005, the Times writes. He resigned in 2006 after complaining about the practices, according to the lawsuit.
Another plaintiff is Alon Vainer, a nephrologist who was a medical director at Gambro and DaVita clinics in Georgia, who says his jobs were not renewed after he filed the lawsuit. Barbir “saw how ridiculous the whole thing was,” but could not get the system changed. “He tried on his level but had to cave in, and I tried on my level and got zero, zero, zero response,” Vainer tells the Times.
So why did DaVita have a protocol if doctors choose the doses? “For many reasons, treating physicians asked for a stronger clinical application tool for iron therapy and we were able to offer one contemporaneously with the new billing system,” the DaVita spokesman wrote the Times in an email. Makes perfect sense, yes?
AnnePME
When you think about the potential for drug diversion and think about how physically and otherwise vulnerable this patient population is, and how easily these types of medicines can become adulterated it sends shivers up your spine. Thank you Ed, and thanks to the New York Times for writing about this.
Selfish
In these days of flying accusations, this is another blight on the pharma industry and extremely hurtful to the poor that could use the drug, rather than throw away the product.
john
Just as a minor point, DaVita is not a pharma company.
Selfish
Thanks for the info. I am aware that DaVita is not a drug company but patient orientation drug delivery, including AMGEN products,as one of their large users of some of their diabetic therapies.
cliffintokyo
Misuse of resources is a serious issue for the US Healthcare *System* (Industry?).
Although it claims to be better for being privately based, its operatives sure behave just the same as the people who squander public funds under nationalised healthcare in *socialised* countries. Reds under the (US hospital) beds?
Americans need a dose of ‘get healthy’, ‘get a life’, ’stay out of hospital’ education!
Fact: Most infections that prove to be fatal are acquired in hospital, under ANY healthcare system.
Amanda wilson
To cliffintokyo, please don’t spout your doctrine in relation to this article. DaVita patients do not have a choice about staying healthy and staying out of hospital. They have end-stage kidney disease and if they do not receive dialysis they die. It’s easy to be self-rioutious about issues such as this when you are’t one of the people with this illness…….but then you could be one day (it isn’t selective in who it affects, and is, in many cases, not caused by lifestyle factors, i.e. You have no control over whether you get it or not)
Anonymous
I worked for Davita for four years and they are the cheapest company I have ever worked for. I know it is a business, but they wouldn’t even let us use band-aids on patients just to save money. This is just one of many examples of how they tried to save money. They did not even care about the patients. They were just numbers. Davita worked their employees to death and never backed up their nurses. One nurse for the whole facility of 12 stations. I worked sometimes 80hrs in one week. I did almost everything. I mean everything. I had to quit for it was a dangerous thankless job.
Anonymous- reply
I also worked for DaVita for six years and “Anonymous” sounds like they have it out for DaVita. They are one of the best companies to work for and are far from “cheap”. I have never heard of such a thing as not being able to use a band-aid…are you making this up? Patient safety and concern comes first at DaVita, no doubt…and the issues with the wasted drugs were not due to trying to get extra money. The problem was availability of the vials and the specific required dosage for each patient. If a dosage only required part of the single use vial (say 8,000ml of a 10,000ml vial), the vials are not manufactured to be re-entered and reused so you could only use the 8,000ml and had to dispose of the rest or you could compromise the patient’s safety and effectiveness of the remainder of the drug in that vial. I am surprised “Anonymous” lasted four years at DaVita being “worked to death” as I have never witnessed anyone else at the company complaining of the same.