Health Affairs
Vol. 29, Issue 7, Pages 1391-1399
July 2010
Abstract
The Medicare
Prescription Drug, Improvement, and Modernization Act, enacted in 2003,
substantially reduced payment rates for chemotherapy drugs administered
on an outpatient basis starting in January 2005. We assessed how these
reductions affected the likelihood and setting of chemotherapy
treatment for Medicare beneficiaries with newly diagnosed lung cancer,
as well as the types of agents they received. Contrary to concerns
about access, we found that the changes actually increased the
likelihood that lung cancer patients received chemotherapy. The type of
chemotherapy agents administered also changed. Physicians switched from
dispensing the drugs that experienced the largest cuts in
profitability, carboplatin and paclitaxel, to other high-margin drugs,
like docetaxel. We do not know what the effect was on cancer patients,
but these changes may have offset some of the savings projected from
passage of the legislation. The ultimate message is that payment
reforms have real consequences and should be undertaken with caution.
Citation
Jacobson, Mireille, Craig C. Earle, Mary Price, and Joseph P. Newhouse. "How Medicare's Payment Cuts For Cancer Chemotherapy Drugs Changed Patterns Of Treatment." Health Affairs 29.7 (July 2010): 1391-1399.