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Medicare Modernization Act results in higher rate of chemotherapy among lung cancer patients

-- Eric Metcalf

Thursday, June 17, 2010 (Last Updated: 06/18/2010)

THURSDAY, June 17 (HealthDay News) -- The Medicare Prescription Drug, Improvement, and Modernization Act, which steeply reduced payment rates for chemotherapy drugs given on an outpatient basis starting in January 2005, has resulted in an increased likelihood that Medicare recipients with lung cancer will receive chemotherapy, according to research published online June 17 in Health Affairs.

Mireille Jacobson, Ph.D., of the RAND Corporation in Santa Monica, Calif., and colleagues analyzed Medicare claims data for 222,478 beneficiaries diagnosed with lung between 2003 and 2005.

The researchers found that chemotherapy within a month of diagnosis increased 2.4 percentage points after implementation of the new system, from 16.5 to 18.9 percent. In those treated with chemotherapy, the percentage receiving carboplatin fell from 55.9 to 53.7 and the percentage receiving paclitaxel fell from 30 to 26.2 percent, consistent with the decline in payment rates, while the percentage receiving docetaxel increased from 9.2 to 9.7 percent.

"In sum, far from limiting access, the Medicare Modernization Act actually increased the likelihood that lung cancer patients received chemotherapy. The legislation's reduction in payment rates was also associated with relative shifts in the agents administered. These changes may have offset some of the savings projected from passage of the bill," the authors write. "The increase in utilization may have important implications for the well-being of Medicare beneficiaries with cancer. Unfortunately, we cannot infer the appropriateness of treatment or health outcomes from these data."

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