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Documentation of Chemotherapy Infusion Preparation Costs in Academic- and Community-Based Oncology Practices

Diana I. Brixner, Gary M. Oderda, Nancy A. Nickman, Roy Beveridge, and James A. Jorgenson

Significant changes in Medicare reimbursement for outpatient oncology services were proposed as part of the Medicare Modernization Act of 2003. The purpose of this study was to identify the “true cost” associated with drug-related handling for the preparation and delivery of chemotherapy doses to estimate the impact of changing reimbursement schema by Medicare. Two academic medical outpatient infusion centers and 2 community cancer centers provided data used to estimate all costs (excluding drug cost) associated with the preparation of chemotherapy doses. The data included both fixed costs (drug storage, space, equipment, and information resources) and variable costs (insurance management, inventory, waste management, pharmacy staff payroll, supplies, and shipping). The average cost for the preparation of chemotherapy doses across all sites was $34.27 (range, $32.08–$41.23). A time-and-motion study was also performed to determine what tasks were conducted by pharmacy staff and how much time was spent in the preparation of the top 15 chemotherapeutic drugs and regimens used in the 4 sites. Data from the 4 centers was projected to show that if 3,990,495 million chemotherapy infusions were administered to a national Medicare population in 2003, when multiplied by the average cost of preparation for infusions determined by the current study ($34.27), the estimated total annual cost to Medicare for chemotherapy preparation by pharmacists is $136,754,263.65. The pharmacists spent most of their days (90% or more) performing tasks directly related to the preparation of these agents. These data provide scientific support for the consideration of appropriate reimbursement for chemotherapy services provided by pharmacists to Medicare beneficiaries.

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Adoption of Gene Expression Profiling for Breast Cancer in US Oncology Practice for Women Younger Than 65 Years

Suzanne C. O'Neill, Claudine Isaacs, Calvin Chao, Huei-Ting Tsai, Chunfu Liu, Bola F. Ekezue, Nandini Selvam, Larry G. Kessler, Marc D. Schwartz, Tania Lobo, and Arnold L. Potosky

multivariable model, we tested several hypothesized interactions individually when added to the main effects model ({age} × {year tested, stage, comorbidity}; {out of pocket pharmacy costs} × {year tested, stage, comorbidity}; {year tested} × {stage}). We only

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Healthcare Cost Trajectories in the Last 2 Years of Life Among Patients With a Solid Metastatic Cancer: A Prospective Cohort Study

Ishwarya Balasubramanian, Eric Finkelstein, Rahul Malhotra, Semra Ozdemir, Chetna Malhotra, and for the COMPASS Study Team

Outcome: Total Healthcare Cost We calculated total healthcare cost (gross cost before tax and subsidy) as the sum of inpatient, outpatient, ED, and pharmacy costs during the last 2 years of life based on patient billing dates and date of death. The cost

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NCCN Patient Advocacy Summit: Delivering Value for Patients Across the Oncology Ecosystem

Terrell Johnson, Lindsey A.M. Bandini, Darryl Mitteldorf, Elizabeth Franklin, Justin E. Bekelman, and Robert W. Carlson

removal for companies with poor billing practices. Panelists stressed that financial toxicity can be addressed from many angles, and high-impact areas for smaller practices to begin addressing financial toxicity include transportation and pharmacy costs

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Abstracts From the NCCN 20th Annual Conference: Advancing the Standard of Cancer Care™

Services Research AB2015-1. Anticipated Impact of Generic Imatinib Market Entry on Tyrosine Kinase Inhibitor–Related Pharmacy Costs Lisa M. Bloudek, PharmD, MS a ; Dinara Makenbaeva, MD b ; and Michael Eaddy, PharmD, PhD a a Xcenda and b Bristol

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Additional Abstracts from the NCCN 21st Annual Conference: Advancing the Standard of Cancer Care™

-treated patients had comparable total adjusted health care costs, significantly higher adjusted pharmacy costs, and significantly lower adjusted chemotherapy-related costs. Conclusions: POM-treated patients had significantly better real-world outcomes compared