Oncologists worry about cuts in Medicare cancer pay

Plans to reform reimbursement rates for chemotherapy drugs could threaten patient access.

By Markian Hawryluk, AMNews staff. July 7, 2003.

Washington -- Dave Johnson, MD, has seen cancer care from all sides. He is deputy director of Vanderbilt-Ingram Cancer Center in Nashville, Tenn. His mother died from cancer, and his brother-in-law travels from Ohio to the center for cancer treatments. And he himself is a cancer survivor.

Now Dr. Johnson is worried that potential changes in the way Medicare pays for chemotherapy might jeopardize the standard of treatment and threaten access to care for thousands of patients.

Medicare now overpays physicians for the cancer drugs they buy, but it vastly underpays them for the practice expenses they incur when delivering the drugs. Lawmakers have been eyeing reductions in Part B payments for those drugs for years for the savings such a move would generate.

At press time, both the House and Senate had begun debate over Medicare reform bills that would use those savings to fund an outpatient prescription drug benefit and increase payments to physicians. But oncologists and their supporters say those bills would devastate cancer care.

"There is no question we need to fix the way we pay for cancer care. And we have to add a prescription drug benefit to Medicare," said Rep. Lois Capps (D, Calif.). "But we should not put the cost of such a benefit on the backs of struggling cancer patients."

The House Ways and Means Committee passed a bill that would take oncologists out of the drug purchasing loop. Specialty pharmacies would bid to provide chemotherapy drugs for Part B procedures and be responsible for collecting co-payments from patients. The drugs would be delivered to physicians in time to administer them to patients.