Another study adds to the numerous other studies over the years that have shown the benefits of the Medicare Modernization Act (MMA). Duke University studies had shown the MMA did not change cancer chemotherapy as feared. They showed that millions of dollars were saved and patient quality was still the same. And since oncology drugs accounted for about 69% of total Part B spending on prescription drugs and related services, the Medicare Part D plan made it more important for Medicare cancer patients. The fact that medical oncologists received no reimbursement for providing oral-dose therapy to cancer patients had been the principal barrier to the availability of the oral-dose protocol. Compared to infusional therapy, oral-dose anti-cancer drugs can make receiving cancer treatment more convenient for patients by allowing flexibility in taking medication without disrupting work or other activities. They often resulted in less time (or not time) spent in office-based oncology practices because of the absence of intravenous administration and its related side-effects.
However, Medicare’s payment cuts for chemotherapy drugs didn’t really change the patterns of treatment. Besides the recent Health Affairs publication (How Medicare’s Payment Cuts For Cancer Chemotherapy Drugs Changed Patterns Of Treatment), a survey in Dr. Neil Love’s “Patterns of Care” and Newhouse and Earle’s previous Michigan/Harvard study (Does reimbursement influence chemotherapy treatment for cancer patients?), they all show results that the Medicare reforms are still not working. An impossible conflict of interest still exists. The existence of profit motive in drug selection has been one of the major factors working against the individualization of cancer chemotherapy. It is way past time to take medical oncologists out of the retail pharmacy business and force them to be doctors again.
http://cancerfocus.org/forum/showthread.php?t=687