Major payment reform program for cancer drugs falls short

A program in which medical oncology practices could opt to receive increased reimbursement from a health plan for less expensive, generic cancer drugs in contrast to their costlier brand-name equivalents did not significantly affect prescribing patterns or spending on cancer care.

A dollar sign made up of many many prescription pills.

Researchers from the Perelman School of Medicine and Wharton found that health care providers who voluntarily contracted for the program already had higher rates of generic drug use and those that did not participate prescribed the costliest cancer drugs. This means the program did not attract the practices with the greatest potential to lower the financial burden of cancer care. The study’s authors say the findings point to an inherent flaw in voluntary payment reform programs, which is particularly important as the Centers for Medicare & Medicaid Services continues to evaluate a way to reform payment in cancer care and other settings. The findings are published in the journal Health Affairs.

“This is a strong and early warning that voluntary payment reform programs should be considered with caution,” says the study’s co-lead author Atul Gupta, an assistant professor of Health Care Management at Wharton.

Read more at Penn Medicine News.