6 Updates on Medicare & GI Reimbursement for Gastroenterologists to Know
One thousand gastroenterologists, randomly selected from the membership of the American College of Gastroenterology, were asked to complete a 19-question electronic survey regarding suitable vaccines for the immune-competent and immunosupressed IBD patient and the barriers to recommending the vaccines. The researchers also assessed the perceived role of the gastroenterologist versus the PCP. The researchers analyzed 108 responses and found only 56 (52 percent) of the gastroenterologists took an immunization history most or all of the time. There was no significant difference between gastroenterologists with smaller practices (less than 40 IBD patients) compared with those with larger practices (greater than 40 IBD patients) in how often they asked their patients about immunization history. In contrast, more academic physicians (67.5 percent) asked their patients about immunization history most or all of the time compared to 42.4 percent of private physicians. Sixty-nine (64 percent) of the respondents thought the PCP was responsible for determining which vaccinations to administer to the IBD patient and ninety (83 percent) believed the PCP was responsible for administering the vaccine. Sixteen of the 108 surveyed gastroenterologists did not regularly recommend immunization against influenza. The most common reasons included “too busy/forgot,” “no specific reason,” and “did not know my patient needed it.” In addition, the researchers found 20 to 30 percent of gastroenterologists would erroneously recommend any of the three queried live, attenuated vaccines (MMR, herpes zoster, varicella) to their immune-suppressed IBD patient. In addition, 24 to 35 percent of gastroenterologists would incorrectly not give the three queried live, attenuated vaccinations to their immune-competent patients. Of the inactivated vaccines, knowledge regarding the HPV vaccine was particularly poor, with only 71 (66 percent) recommending the vaccine to their immune-competent patients and only 51 (47 percent) recommending the vaccine to their immune-suppressed patients). In general, gastroenterologists were more likely to make the correct vaccine recommendations for their immunocompetent IBD patients. “Gastroenterologist knowledge of the appropriate immunizations to recommend to the IBD patient is limited and may be the primary reason why the majority of gastroenterologists believe that the PCP should be responsible for vaccinations,” said primary author Sharmeel Wasan, MD, MSc, an assistant professor of medicine at BUSM and a gastroenterologist at BMC. Over the last five years, the problem of vaccine preventable illnesses in patients with IBD have been described, including case reports of fulminant hepatitis and fatal varicella. “Despite an increased risk for infections on these agents, many IBD patients are not being appropriately vaccinated.
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Gastroenterologists Unlikely To Use Celltrion/Hospira’s Infliximab Biosimilar Due To Lack Of Clinical Data In Inflammatory Bowel Disease
3. Medicare/Medicaid beneficiaries Despite the cuts and uncertainty surrounding Medicare payments, 58 percent of gastroenterologists plan to see both current and new Medicare and Medicaid patients, according to Medscape’s Gastroenterologist Compensation Report: 2013 . Only 12 percent of gastroenterologists intend to drop or stop taking on new Medicare and Medicaid patients, while 30 percent remain undecided. 4. Gastroenterologist compensation While reimbursement pressure is a reality, overall gastroenterologist compensation remains steady. From 2011 to 2012, 72 percent of gastroenterologists’ received the same level of compensation or higher, according to Medscape’s report. Compensation varied by gender, geographic location and practice setting. Men earned more than women. GI physicians in the northwestern U.S. earned the most and those in the Mid-Atlantic region earned the least. Partners in a practice earned the most, while employed gastroenterologists earned the least. 5. ASCs and endoscopy centers For two years in a row, the Medicare Payment Advisory Commission has recommended that Congress give ambulatory surgery centers a 0 percent pay increase. On the other hand, MedPAC recommended a 3.25 to 5.25 percent increase for hospital outpatient departments in 2015, depending on whether or not sequestration continues. ASC reimbursement as a percentage of HOPD reimbursement has been steadily declining since 2003.
0 Comments Gastroenterologists Unlikely To Use Celltrion/Hospira’s Infliximab Biosimilar Due To Lack Of Clinical Data In Inflammatory Bowel Disease Rheumatologists Expect More Extensive Clinical Trials for Biosimilars than Gastroenterologists, According to a New Report from BioTrends Research Group PR Newswire EXTON, Penn., Sept. 30, 2013 EXTON, Penn., Sept. 30, 2013 /PRNewswire/ — BioTrends Research Group, one of the world’s leading research and advisory firms for specialized biopharmaceutical issues, finds that the majority of surveyed gastroenterologists do not expect to prescribe an infliximab biosimilar, such as Celltrion’s Remsima, in their Crohn’s disease (CD) or ulcerative colitis (UC) patients that has not been clinically tested in inflammatory bowl diseases. The Biosimilars Advisory Service report entitled Physician Perspectives on Pegylated IFN-a and TNF-a Inhibitors in Immune and Infectious Disease provides analysis of survey results from over 90 gastroenterologists, as well as more than 90 rheumatologists in the United States and Europe. The report finds that over 70 percent of surveyed gastroenterologists would not use biosimilar infliximab in CD or UC patients if the clinical trial had only been conducted in rheumatoid arthritis patients. Only a minority of survey respondents believe that indication extrapolation is an overall good idea. The report also finds that surveyed rheumatologists are similarly cautious about indication extrapolation, but most biosimilars of TNF-alpha inhibitors under development are being studied in rheumatoid arthritis patients. This strategy by biosimilar manufacturers could help to alleviate rheumatologists’ concerns about prescribing these biosimilar TNF-alpha inhibitors, but this study also reveals that rheumatologists would prefer a longer treatment duration and more patients to be included in biosimilar clinical trials compared with their gastroenterology counterparts. “The concept of indication extrapolation is particularly relevant to prescribers of TNF-alpha inhibitors because of the breadth of indications that these biologics are used in,” said Biosimilars Research Director Kate Keeping. “The first biosimilar TNF-alpha inhibitor that gastroenterologists will have access to, Celltrion/Hospira’s Inflectra (infliximab), has not been clinically tested in CD or UC patients, which will likely limit uptake in these patients, at least until direct clinical evidence is available.” The Biosimilars Advisory Service provides insight and analysis that is vital to successful business planning in the rapidly evolving biosimilars space. The service includes quarterly webinars detailing major developments, analyst insight addressing key market changes and opportunities, therapeutic area-specific primary research and forecasting modules. About BioTrends Research Group BioTrends Research Group provides syndicated and custom primary market research to pharmaceutical manufacturers competing in clinically evolving, specialty pharmaceutical markets.