| 20. Dr. Jones believes that two treatments are of equal value to his patients. He chooses the one for which he will receive the higher reimbursement. |
| # | Response Date | Comment |
| 1. | Wed, 3/14/07 12:23 AM | Depends on overall cost to system. If the same or lower, no COI. If higher and attributable to the higher reimbursement to Dr. Jones, then moderate. |
| 2. | Wed, 3/14/07 2:23 AM | As long as there is no increased cost to the patient |
| 3. | Wed, 3/14/07 12:53 PM | on the value to the patient - if it was no more expensive and just as beneficial to the patient then ok - this is a systems based effect |
| 4. | Wed, 3/14/07 2:56 PM | Are the costs to the patient/insurer the same or different |
| 5. | Wed, 3/14/07 10:10 PM | Is the patient part of this decison-making? (Including the cost/reimbursement discussion). If it is explicit and patient concurs theb this may be okay for the patient. |
| 6. | Thu, 3/15/07 8:19 PM | If the cost to the patient is the same for both,then it is ok. |
| 7. | Fri, 3/16/07 2:39 PM | If the drug in which he receives reimbursement from is cheaper for his patients, that would be ok. |
| 8. | Mon, 3/19/07 1:46 PM | on whether he discloses this to his patients. |
| 9. | Mon, 3/19/07 4:58 PM | A very serious COI. The treatment receiving higher reimbursement will almost invariably involve greater cost to the patient and is therefore a breach of ethics. The physican should explain both options to the patient, including the less expensive generic option, provide impartial information about efficacy, and leave the decision to the patient. |
| 10. | Mon, 3/19/07 5:30 PM | Did he have the higher reimbursement in mind? Does the higher reimbursement support those services that are inadequately reimbursed? |
| 11. | Wed, 4/25/07 12:53 AM | if they are of equal cost to the patient, I don't have a problem with this |
| 12. | Tue, 5/8/07 3:29 PM | .... |