Blog | Monday, April 9, 2012

QD: News Every Day--Hospital-based chemo costs 24% more than outpatient treatment


Hospital outpatient chemotherapy costs 24% more than treatment received in a physician's office, a health care advisory company announced.

A study found that from 2008 to 2010, the average cost of care for privately insured patients receiving chemotherapy in a hospital outpatient setting was approximately $35,000 versus $28,200 for those receiving treatment in a physician's office.

Care for patients treated in a physician's office is less expensive regardless of the length of the chemotherapy, study authors reported in a press release. The average chemotherapy treatment lasted 3.8 months for patients treated in a physician's office versus 3.4 months for patients treated in a hospital outpatient setting.

For chemotherapy therapy lasting only one month, patients treated in a hospital outpatient setting cost 28% more than patients managed in a physician's office. For patients receiving a full 12 months of chemotherapy, hospital outpatient care costs 53% more than in the physician office-based setting. These results are adjusted for the effect of age, sex, and prior history of cancer, but do not reflect other patient acuity factors that could influence total costs of care.

Patient acuity could influence cost, as could billing practices and institutional norms. For example, patients treated in the hospital outpatient setting had to be admitted for inpatient hospital care at a higher rate than patients treated in a physician's office, and controls were not available in the data.

The study also explored costs of patients receiving radiation in a freestanding radiation treatment facility and in a hospital outpatient setting. Approximately 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 a freestanding facility.

Approximately one-third of 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 versus 1.9 months for patients managed in a hospital outpatient setting. These estimates are adjusted for age, sex, and prior history of cancer, but do not adjust for the specific modality of radiation therapy.

The Community Oncology Alliance commissioned the study in partnership with the National Association of Managed Care Physicians Medical Directors Institute, to analyze data provided by NAMCP members. The data analyzed is from three large commercial managed care plans and one large self-funded employer, covering an estimated 9 million individuals. Amgen and Millennium Pharmaceuticals provided funding for the study.