title: Does reimbursement influence chemotherapy treatment for cancer patients?
abstract: Before the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, Medicare reimbursed physicians for chemotherapy drugs at rates that greatly exceeded physicians' costs for those drugs. We examined the effect of physician reimbursement on chemotherapy treatment of Medicare beneficiaries older than age sixty-five with metastatic lung, breast, colorectal, or other gastrointestinal cancers between 1995 and 1998 (9,357 patients). A physician's decision to administer chemotherapy to metastatic cancer patients was not measurably affected by higher reimbursement. Providers who were more generously reimbursed, however, prescribed more-costly chemotherapy regimens to metastatic breast, colorectal, and lung cancer patients.
authors.affiliation: University of Michigan, Ann Arbor, USA. mgjacobs@umich.edu
authors.forename: Mireille
authors.initials: M
authors.lastname: Jacobson
authors.forename: A James
authors.initials: AJ
authors.lastname: O'Malley
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
authors.forename: Juliana
authors.initials: J
authors.lastname: Pakes
authors.forename: Peter
authors.initials: P
authors.lastname: Gaccione
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Newhouse
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000191:economics; D004363:Drug Utilization / Q000191:economics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000191:economics; D008297:Male; D008495:Medical Oncology / Q000191:economics*; D016345:Medicare Part B / Q000331:legislation & jurisprudence*; D009362:Neoplasm Metastasis / Q000188:drug therapy; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms; D018426:SEER Program; D014481:United States
chemical_list: D000970:Antineoplastic Agents