Andrew L. Pecora, MD
The debate continues to rage over whether the difference in the cost of oncologic care between outpatient hospital and physician private offices is appropriate. There is a particularly large pricing gap for chemotherapy administration. Numerous studies have shown that chemotherapy in the outpatient hospital setting costs more than in the private physician office, with a recent report showing it to be 60% more expensive. An economic study by Lucio Gordan, MD, medical director in the Division of Quality & Informatics at Florida Cancer Specialists & Research Institute, and Xcenda found that 1 year of all-related treatment for 3 common cancers— lung, breast, and colon—was as much as ,000 more costly in the hospital outpatient setting than in the private office. The higher cost was largely due to chemotherapy charges, although physician visits contributed to the added expense in the hospital outpatient setting. Compounding this was the finding that emergency department visits after chemotherapy administration were more frequent in the hospital setting: 9.8% versus 7.9% in the private physician office.
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