There’s so much waste in U.S. cancer care that any pet issue represents but a drop in the proverbial bucket, but here’s one of mine: physicians don’t push self-administration of GSCFs like Neulasta because they can bill the in-office delivery of the drug as an outpatient procedure. So instead of faxing a prescription to a specialty pharmacy to have a box of pre-filled syringes delivered to the patient’s house, which would be charged exclusively under the patient’s pharmacy benefits, the physician/center will have the patient return for a separate appointment after chemo to have a simple subcutaneous injection billed as a medical benefit. Even medical staff aren’t consistently aware that home administration is an option; a nurse once asked after a dose of Abraxane if I had an appointment for Neulasta for the next day, and I told her I’d be giving it myself at home. She raised her eyebrows and said, “Do you have someone at your house that can give injections?”

It’s a subcutaneous injection. You cannot do it wrong. Continue reading “Make $$$ [for your doctor] from home!” →