Cost analysis of second-line therapies for platinum-refractory ovarian cancer: Reimbursement dilemmas for medicare patients

Tammy J. Stinson, Elizabeth Calhoun, Teresa Yang, John R. Lurain, Charles L. Bennett

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Currently used options for salvage therapy for epithelial ovarian cancer include intravenously administered paclitaxel or topotecan and orally administered altretamine or etoposide. The response rates for these agents are similar (14-26%), whereas the type and incidence of adverse events differ. Under current legislation, Medicare will reimburse intravenous outpatient chemotherapy regimens only or oral regimens with a marketed intravenous formulation, despite that 89% of cancer patients prefer oral therapies. To compare the out-of-pocket costs and costs to the Medicare system, a cost minimization analysis of treatment with these agents was conducted using published phase II and phase III data. The total cost of treatment was $15,767 for paclitaxel, $18,635 for topotecan, $4477 for altretamine, and $5016 for etoposide. The out-of-pocket costs to the patient were $83, $37, $4477, and $6, respectively. Although a physician's first consideration in choosing a therapy is efficacy and toxicity, current Medicare reimbursement policies restrict patient options for cancer care. Because Medicare adopts managed care and health maintenance organizations into the management of patient care, cost effectiveness will likely become an important consideration in the treatment of cancer.

Original languageEnglish (US)
Pages (from-to)559-565
Number of pages7
JournalCancer Investigation
Volume17
Issue number8
StatePublished - 1999
Externally publishedYes

Fingerprint

Medicare
Platinum
Ovarian Neoplasms
Altretamine
Topotecan
Costs and Cost Analysis
Etoposide
Health Expenditures
Paclitaxel
Patient Care Management
Salvage Therapy
Neoplasms
Health Maintenance Organizations
Managed Care Programs
Therapeutics
Legislation
Health Care Costs
Cost-Benefit Analysis
Outpatients
Physicians

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cost analysis of second-line therapies for platinum-refractory ovarian cancer : Reimbursement dilemmas for medicare patients. / Stinson, Tammy J.; Calhoun, Elizabeth; Yang, Teresa; Lurain, John R.; Bennett, Charles L.

In: Cancer Investigation, Vol. 17, No. 8, 1999, p. 559-565.

Research output: Contribution to journalArticle

Stinson, Tammy J. ; Calhoun, Elizabeth ; Yang, Teresa ; Lurain, John R. ; Bennett, Charles L. / Cost analysis of second-line therapies for platinum-refractory ovarian cancer : Reimbursement dilemmas for medicare patients. In: Cancer Investigation. 1999 ; Vol. 17, No. 8. pp. 559-565.
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