HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, January 21, 2010

Cancer Therapy Costs Influence Treatment: A National Survey of Oncologists

A new article in Health Affairs reports on a national survey of the treatment recommendations of 1,379 oncologists. The survey indicates that rising drug costs are influencing practice, even though oncologists generally don’t communicate with patients about costs. Hat tip to Ed Silverman at Pharmalot who summarizes the findings:

84 percent of oncologists say patient out-of-pocket spending influences treatment recommendations and 56 percent strongly or somewhat agreed that costs influence their treatment decisions. Yet only 43 percent always or frequently discuss costs with patients. The survey notes prices rose 14 percent annually in recent years.

Meanwhile, 73 percent agreed with the statement that “over the next 5 years, costs of new cancer drugs will play a more significant role in my decisions regarding which cancer treatments to recommend for my patients.” The results also found 79 percent favor more comparative effectiveness research and 80 percent support more cost-effectiveness data, but only 42 percent feel well prepared to interpret it. And 58 percent believe patients should have access to effective cancer treatment only if the treatments are cost-effective or provide good value for money. What’s good value? The most popular response, or 49 percent, was $50,001 to $100,000 per life-year gained.

The results suggest docs support federally funded comparative effectiveness research but they wish to retain a central role in making decisions about how and when to use expensive cancer meds. “This finding has special relevance in light of the recent American Recovery and Reinvestment Act, which provides $1.1 billion to fund comparative effectiveness research, and in light of provisions of health reform legislation that would expand the research even further,” the authors conclude.

January 21, 2010 | Permalink | Comments (0) | TrackBack (0)

Wednesday, January 20, 2010

Scott Brown and the Health Care Debate

Will the health care bill still pass? According to the Wall Street Journal Blog, the key points from the Washington coverage found in the WSJ, Washington PostNew York Times and Politico are as follows:

Scott Brown’s win in Massachusetts means the Dems no longer have a filibuster-proof majority in the Senate. That means Republicans could (and almost certainly would) block any wholesale changes to the Senate health-care bill.

The House could pass the same version of the health-care bill that already passed the Senate, and send it to the President’s desk. Some further tweaks to the health-care overhaul could be made under a process known as reconciliation, which requires only a simple majority in the Senate.

Or House Dems could balk, both because they don’t like some of the provisions in the Senate bill, and because of popular opposition to the health-care overhaul. Rep. Anthony Weiner, a New York Dem who had earlier pushed for a single-payer system, seems to be in this camp. “I don’t think I can vote for the Senate bill, and I don’t think there are the votes in the House for the Senate bill,” he said, according to the WSJ.

January 20, 2010 | Permalink | Comments (0) | TrackBack (0)

Tuesday, January 19, 2010

California Caps Patient Wait Times for HMOs

California regulators are implementing new rules that limit the long waits that many people endure to see a doctor when they are members of health maintenance organizations. The LA Times reports that  

[t]he regulations by the California Department of Managed Health Care, in the works for much of the last decade, will require that patients be treated by HMO doctors within 10 business days of requesting an appointment, and by specialists within 15.

Patients seeking urgent care that does not require prior authorization must be seen within 48 hours. Telephone calls to doctors' offices will have to be returned within 30 minutes, and physicians or other health professionals will have to be available 24 hours a day.

California says it is the first state to set time standards for HMOs, which serve nearly 21 million of its residents. The managed healthcare department acted in response to a 2002 law that mandated more timely access to medical care. The law left it to state officials to work out the details, which became subject to protracted negotiations with HMOs, doctors, hospitals, consumer groups and other healthcare activists.

In all, it took seven years to finally reach agreement amid intensive talks, bureaucratic hurdles and a lengthy rule-writing process, participants said.

After the rules are unveiled Wednesday, HMOs will be given nine months to submit plans that meet the new guidelines, allowing for the fact that many HMOs will need to revise their contract agreements with physician networks and other groups.

HMOs will be given until January 2011 to comply; after that, the managed healthcare department will have the authority to penalize HMOs that fail to ensure timely care. People will be able to complain to the department about delays.

January 19, 2010 | Permalink | Comments (0) | TrackBack (0)

Monday, January 18, 2010

Will Democrats Attempt to Push the Health Care Bill Through the House?

According to the New York Times, "White House and Democratic Congressional leaders, scrambling for a backup plan to rescue their health care legislation if Republicans win the special election in Massachusetts on Tuesday, have begun laying the groundwork to ask House Democrats to approve the Senate version of the bill, which would send the measure directly to President Obama for his signature."

January 18, 2010 | Permalink | Comments (0) | TrackBack (0)