The Journal of the National Cancer Institute published an online study which suggests that cuts in payments for Medicare has reduced the amount of treatments done for patients with low-risk prostate cancer.
In contrast, the frequency of use of the same therapy for metastatic prostate cancer was not reduced, according to the new study.
Researchers concluded that the lower Medicare payments probably helped to reduce the amount of over-treatment for low-risk cancer, while not affecting the amount the higher-risk cancer was treated. The amount both types of prostate cancer was treated with androgen suppression therapy more than tripled in the period between 1991 and 1999, even though there was no evidence that this treatment improves the survival rate of persons with the low-risk illness.
In 2004 and 2005 the reimbursement schedule for doctors using androgen suppression therapy was reduced by 64%. The use of the therapy for patients with low-risk prostate cancer fell by 40%. No significant reduction in the use of the therapy for metastatic prostate cancer was observed during those years.
The conclusion by the researchers of the study was that the decline in use of androgen therapy “likely represents a real effect of reimbursement change and not physician awareness of clinical evidence.”