News and Commentary

Chemo Payment Cut No Harm to Patients

Patients undergoing chemotherapy have not lost access to care, despite federal legislation that reduced payments to oncologists, according to a study issued by the Duke University Clinical Research Institute (DCRI).

Critics of Medicare Part D feared that if the payment schedule for oncologists were reduced and they weren’t being paid as much for the chemotherapy drugs they were giving their patients, “patient care might suffer if doctors had to close their practices or scale back, making it necessary for patients to travel farther or go to inpatient facilities for treatment,” says Kevin Schulman, director of DCRI’s Center for Clinical and Genetic Economics. “Our study showed that this, in fact, has not yet occurred.”

Researchers at DCRI studied the treatment of patients with leukemia, lymphoma, breast, lung or colorectal cancer from 2003, before the act was passed, through 2006.

“The distance patients traveled for chemotherapy treatments did not considerably increase after passage of the act,” says lead investigator, Lesley Curtis, a health services researcher at DCRI. “And despite concerns that patients would have to go to inpatient settings with longer wait times, we observed a small shift in the provision of initial chemotherapy from inpatient to outpatient settings,” says Curtis.

The median amount of time between diagnosis and treatment was 28 days. This did not change significantly, regardless of treatment setting, says Curtis.

The findings were published in the Journal of the American Medical Association.


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