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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Diana I. Brixner, Gary M. Oderda, Nancy A. Nickman, Roy Beveridge, and James A. Jorgenson
Maxwell T. Vergo and Amelia M. Cullinan
delegates different aspects of care to various subspecialists. (C) The Integrated Care Model: the oncology team is responsible for cancer therapy/management, whereas the palliative care specialist is responsible for most symptom and psychosocial issues
Fay Fieruzeh Ansary and Natasha Olson
management of symptoms in myelofibrosis. Authors of this PQI from Atrium Health reviewed current data and best practices for specific therapy management and developed a comprehensive workflow ( Figure 1 ). Thereafter, content was created based on evidenced
Use in Patients with Cancer; Optimizing Oral Therapy in Kidney Cancer Management of Cardiovascular Toxicities Associated with TKI Therapy Management of Hypersensitivity Reactions to Systemic Therapy Safe Handling of Hazardous Drugs Implementing
Jeffrey A. Gilreath, Daniel S. Sageser, James A. Jorgenson, and George M. Rodgers
patterns and outcomes of hematopoietic agents at the Huntsman Cancer Institute . Presented at the Western States Residency Conference; May 2004; Asilomar, CA . 23. Kuo GM Buckley TE Fitzsimmons DS Steinbauer JR . Collaborative drug therapy
Siu-Fun Wong, Mark Bounthavong, Cham P. Nguyen, and Timothy Chen
care professionals provide medication therapy management (MTM) services, may be a possible model that can assist with the multitude of potential safety and efficacy concerns associated with oral chemotherapy. MTM services have been successfully
optimizing patient care in the management of patients. The program agenda includes the following topics: Optimizing the Care of Patients Receiving CAR T-Cell Therapy, Management of Toxicities Associated with Immune Checkpoint Inhibitors, Strategies to
Hema Sundar and Jerald Radich
interactions and work with patients to maximize the benefits of TKI therapy. Management of Resistance to TKI Therapy Point mutations in the BCR-ABL1 kinase domain are the most frequent mechanism of resistance to TKI therapy, with T315I mutation
Jonas A. de Souza, Mark J. Ratain, and A. Mark Fendrick
Asheville Project: long-term clinical, humanistic, and economic outcomes of a communitybased medication therapy management program for asthma . J Am Pharm Assoc 2006 ; 46 : 133 - 147 . 5 Agency for Healthcare Research and Quality: Glossary of
Crystal S. Denlinger, Jennifer A. Ligibel, Madhuri Are, K. Scott Baker, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Lee Jones, Allison King, Grace H. Ku, Elizabeth Kvale, Terry S. Langbaum, Kristin Leonardi-Warren, Mary S. McCabe, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Mary Ann Morgan, Javid J. Moslehi, Tracey O’Connor, Linda Overholser, Electra D. Paskett, Muhammad Raza, Karen L. Syrjala, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Nicole McMillian, and Deborah Freedman-Cass
J Hester J Ahmedzai S . Cancer pain: part 2: physical, interventional and complimentary therapies; management in the community; acute, treatment-related and complex cancer pain: a perspective from the British Pain Society endorsed by the UK
