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US chemotherapy "costs 24% more in hospital than in a doctor's office"

World News | April 12, 2012


Lynne Taylor

US chemotherapy "costs 24% more in hospital than in a doctor's office"

In the US, treatment for privately-insured patients receiving chemotherapy in a hospital outpatient setting costs 24% more on average than treatment received in a physician's office, a new study shows.

From 2008 to 2010, the average cost of care for patients in these plans receiving chemotherapy in a hospital outpatient setting was around $35,000, compared to $28,200 for those receiving the treatment in a physician's office, says the research, from Avalere Health.

Treatment in a doctor's office is less expensive regardless of the length of the chemotherapy duration, the study also finds. The average chemotherapy treatment lasted 3.8 months for patients treated in a physician's office compared to 3.4 months for those treated in a hospital outpatient setting. For chemotherapy lasting only one month, people treated as hospital outpatients cost 28% more than those managed in a doctor's office, while for those receiving a full 12 months' chemotherapy, hospital outpatient care cost 53% more than that given in the physician office-based setting, it says.

Commenting on the research results, Eric Hammelman, Avelere vice president and an author of the study, said: "at a time when the healthcare community is focused on managing costs, these findings show the importance of where care is delivered, and raise important questions about how best to manage cancer treatment."

The study also explored the costs of patients receiving radiation therapy in a freestanding radiation treatment facility and in a hospital outpatient setting. Here, it found that around two-thirds of the treatment episodes lasted one or two months and cost approximately 15% and 4% more, respectively, in the hospital outpatient setting versus the freestanding facility.

Around a third of the treatment episodes lasted three months and were about 8% more expensive in the freestanding location versus the hospital outpatient setting. The average radiation therapy episode lasted 2.1 months for patients managed in a physician's office, compared to 1.9 months for those managed in a hospital outpatient setting, the research shows.

These new findings are consistent with a study published last October by consulting firm Milliman which found that the total healthcare costs for Medicare (the US federal government's healthcare programme for people aged 65 and over and some disabled people) and for seniors receiving chemotherapy were higher in an outpatient hospital setting than for those receiving their treatment in a doctor's office.

David Eagle, president of the Community Oncology Alliance, called on policymakers to "thoughtfully consider" this documentation on the cost efficiency of care for cancer patients provided by community oncologists for private payers, Medicare and patients, "as medical care is rapidly being consolidated, to ensure that affordable cancer care remains accessible to Americans."

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