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U Researcher Briefs Bush Adviser, Congressional Staff on Study of Medicare Reimbursement for Chemotherapy


A researcher from the University of Utah Pharmacotherapy Outcomes Research Center presented the findings of the first major study on appropriate Medicare reimbursements for chemotherapy services to cancer patients on Feb. 15–16 to federal officials in Washington, D.C.

Gary M. Oderda, Pharm.D., M.P.H., professor of pharmacotherapy and an investigator on the study, met with Doug Badger, special adviser to the president on economic issues, officials from the Centers for Medicare and Medicaid Services (CMS), and congressional staffers from the House Ways & Means Committee, House Energy & Commerce Committee, and the Senate Finance Committee during the two-day briefing.

The Pharmacotherapy Outcomes Research Center, part of the U College of Pharmacys Department of Pharmacotherapy, was the coordinating center of four nationwide to participate in the study to determine the costs of preparing chemotherapy for delivery to patients. The CMS pays health-care providers for chemotherapy services, but until now hasnt had hard data to help determine reimbursement rates.

The study found the average fixed cost for the preparation of chemotherapy at the U of U, University of Wisconsin, and community cancer centers in Fairfax, Va., and Montgomery, Ala., was $36.03 per dose or infusion. The annual cost to Medicare for chemotherapy preparation reimbursements, according to the study, totals $144 million.

The findings will assist the CMS in determining an accurate reimbursement level for health-care providers, according to Diana I. Brixner, R.Ph., Ph.D., associate professor and chair of pharmacotherapy and the studys principal investigator at the U of U.

"This is the first study to provide actual data on the cost of drug preparation," Brixner said. "Until now, reimbursements have been based on secondary sources."

Funded by the National Patient Advocate Foundation, the study looked at costs related to chemotherapy that included drug storage, space, insurance, inventory and waste management, pharmacy staff payroll, equipment and other supplies, information sources, and shipping. These costs were annualized and divided by the number of chemotherapy doses given at each site in a year, according to Brixner.

Another component of the study also showed that pharmacists who prepare chemotherapy drugs spend 90 percent or more of their day on tasks directly related to preparing the agents.