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Chemotherapy Concessions

Posted 1/4/2013

Posted in

  As we all know, there is growing concern about the cost of health care in general in the US and cancer drugs and care in specific (for our purposes). Since I work in a big academic medical center, this particular issue is not relevant in my world, but it is surely relevant to the larger community. In settings like BIDMC. the hospital buys the drugs and all sorts of rules and regulations are in place to monitor the cost and distrbution.

  The set up is very different in some private oncology practices. Actually, in some offices, patients buy their own drugs at designated pharmacies and show up at the treatment center with Taxol of whatever in hand. (By the by, this feels very weird to me, but I guess it wouldn't if I were used to it.) More often, the offices/practices have a system in place to buy the drugs and then sell them directly to patients. This is a big money making operation, often bringing in more than half of the total revenues for the practice. It costs a lot of money to run an oncology practice: salaries for, yes, the oncologists, but also chemotherapy nurses, social workers, administrative staff, pharmacists, and all the operating costs for the facility itself. This is to say that this is not a simple problem to solve. What may on the surface seem a bit smarky may actually support a very good system of care.

  This is an article from MedScape about this concern. I give you the start and then a link to read more:

A new study confirms that financial incentives exist for some US oncologists in the prescribing of chemotherapy and growth factors for treatment-related anemia.

These potential "inducements" are not widespread, existing for only about 25% of 480 medical oncologists surveyed, and are mostly among fee-for-service clinicians or those with financial incentives in their salary structure, found the authors, who were led by Jennifer Malin, MD, PhD, of the University of California, Los Angeles. She is also medical director of oncology of WellPoint, a managed care company headquartered in Indianapolis, Indiana.

Such financial incentives need to be "decreased" because they may be contributing to rising cancer costs, Dr. Malin and colleagues explain.

"Eliminating the chemotherapy concession" is a "potentially effective solution" to these financial temptations, the authors write in the discussion section of the study, which was published online December 26th in the Journal of Clinical Oncology.




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