Bye bye APM, we hardly knew thee...

[Lnsean]

Growth in drug spend is unsustainable and likely eclipses growth in cancer spending elsewhere

Americans now spend twice as much on cancer drugs as in 2012

Every new cancer drug cost $100,000 or more in 2017.

www.nbcnews.com

Growth in healthcare cost in general is unsustainable; it's not specific to drugs. How about a reputable source like CMS instead of some news clickbait headline?

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf

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[medgator]

Growth in healthcare cost in general is unsustainable; it's not specific to drugs. How about a reputable source like CMS instead of some news clickbait headline?

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf

Why not something focused on oncology? You know, to fit the forum? Or at least a link to back up end of life care being the big driver of oncology spending?

I don't need any links to tell you rad onc spending hasn't kept pace with oncology drug spending esp as practices have been bought up and care has moved into more expensive settings.

Landmark Study Takes In-Depth Look at Cost Drivers of Cancer Care - Community Oncology Alliance

New Milliman Study Commissioned by Community Oncology Alliance Finds Costs for Treating Patients With Cancer Increased at Essentially Same Rate as Other

www.communityoncology.org

ASCO: Study examines Medicare expenditures for cancer treatments

Cancer is the second most costly medical condition in the United States behind heart disease, and a study presented at the American Society of Clinical Oncology (ASCO) sought to better understand Medicare costs.

www.medicaleconomics.com

 

[Lnsean]

Why not something focused on oncology? You know, to fit the forum? Or at least a link to back up end of life care being the big driver of oncology spending?

I don't need any links to tell you rad onc spending hasn't kept pace with oncology drug spending esp as practices have been bought up and care has moved into more expensive settings.

Landmark Study Takes In-Depth Look at Cost Drivers of Cancer Care - Community Oncology Alliance

New Milliman Study Commissioned by Community Oncology Alliance Finds Costs for Treating Patients With Cancer Increased at Essentially Same Rate as Other

www.communityoncology.org

ASCO: Study examines Medicare expenditures for cancer treatments

Cancer is the second most costly medical condition in the United States behind heart disease, and a study presented at the American Society of Clinical Oncology (ASCO) sought to better understand Medicare costs.

www.medicaleconomics.com

Because it wasnt what we were talking about. My post was about drug cost being 10% of medical expenditure...and this includes oncology...its everything....and I provided a CMS link to prove it. You are bringing up points no one is arguing and your links aren't even relevant to what is being discussed.

 

[medgator]

Because my post was about drug cost being 10% of medical expenditure, and I provided a CMS link to prove it. You are bringing up points no one is arguing and your links aren't even relevant to what is being discussed.

Says the guy who hijacked the thread originally....

The bottom line is that azar is a pharma guy, rad onc has weak lobbyists and he's going for the low hanging fruit, which is how we ended up with mandatory APM to begin with, something he created

 

[Lnsean]

Says the guy who hijacked the thread originally....

You're the guy that linked nbcnews...as a physician you should know better than that....rad onc even.

 

[medgator]

You're the guy that linked nbcnews...as a physician you should know better than that....rad onc even.

Doesn't make it incorrect

Report: US spending on cancer drugs doubles in five years

The IQIVA Institute for Human Data Science has published its annual global oncology trend report, painting a field flooded with investment and highly-priced the

www.thepharmaletter.com

 

[Lnsean]

Doesn't make it incorrect

Report: US spending on cancer drugs doubles in five years

The IQIVA Institute for Human Data Science has published its annual global oncology trend report, painting a field flooded with investment and highly-priced the

www.thepharmaletter.com

You're making a point no one is arguing. I said drug costs are only 10% of healthcare expenditure...if you are refuting that then provide evidence for such.

 

[medgator]

You're making a point no one is arguing. I said drug costs are only 10% of healthcare expenditure...if you are refuting that then provide evidence for such.

Says the guy who did exactly that when he posted in this thread lol.

Maybe you should look at growth in oncology drug spending instead of picking a static figure on overall drug spending, from 2017, in a thread on APM in the radiation oncology forum. Maybe...

 

[Lnsean]

Says the guy who did exactly that when he posted in this thread lol.

Maybe you should look at growth in oncology drug spending instead of picking a figure on overall drug spending from 2017

Huh? Growth or not...the end result is that only 10% of healthcare cost is attributed to drugs. The bigger pie is hospital care and physician clinical services. Do you know how to read a pie chart?

 

[medgator]

Huh? Growth or not...the end result is that only 10% of healthcare cost is attributed to drugs. The bigger pie is hospital care and physician clinical services. Do you know how to read a pie chart?

You're actually wrong about that too, so probably should quit while you're behind. Or at least try to make your posts relevant to this thread/forum....

CMS Unveils Enhanced “Drug Dashboards” to Increase Transparency on Drug Prices | CMS

Today, the Centers for Medicare & Medicaid Services released a redesigned version of the Drug Spending Dashboards. For the first time, the dashboards include year-over-year information on drug pricing and highlight which manufactures have been increasing their prices.

www.cms.gov

The Centers for Medicare & Medicaid Services spent $174 billion on prescription medications in 2016, or 23% of its total budget. That's up from $109 billion, or 17% of the budget, in 2012

 

[Lnsean]

You're actually wrong about that too, so probably should quit while you're behind....

CMS Unveils Enhanced “Drug Dashboards” to Increase Transparency on Drug Prices | CMS

Today, the Centers for Medicare & Medicaid Services released a redesigned version of the Drug Spending Dashboards. For the first time, the dashboards include year-over-year information on drug pricing and highlight which manufactures have been increasing their prices.

www.cms.gov

The Centers for Medicare & Medicaid Services spent $174 billion on prescription medications in 2016, or 23% of its total budget. That's up from $109 billion, or 17% of the budget, in 2012

Huh? I said it's 10% of TOTAL HEALTHCARE EXPENDITURE not total budget. It's a pie chart...I can only explain it to you...I cannot understand it for you. Also, my data is 2017 not 2016. You should provide the same integrity of data that I have provided you...not subpar.

I'm baffled that you're an attending...rad onc has declined much I see.

 

[medgator]

Huh? I said it's 10% of TOTAL HEALTHCARE EXPENDITURE not total budget. It's a pie chart...I can only explain it to you...I cannot understand it for you. Also, my data is 2017 not 2016.

Expenditure vs budget. Makes total sense.

 

[Lnsean]

Expenditure vs budget. Makes total sense.

of course. learn to read next time. it's all in the report. CMS has a budget. Total expenses will rarely be what the budget is.

and also, the link i provided shows all spending (CMS and private insurance). You're only talking about CMS in your posts.

 

[medgator]

of course. learn to read next time. it's all in the report. CMS has a budget. Total expenses will rarely be what the budget is

The Centers for Medicare & Medicaid Services spent $174 billion on prescription medications in 2016, or 23% of its total budget. That's up from $109 billion, or 17% of the budget, in 2012

and also, the link i provided shows all spending (CMS and private insurance). You're only talking about CMS in your posts.

I'm guessing you don't know the demographics of our patients.... Again you're in the rad onc forum

 

[Lnsean]

I'm guessing you don't know the demographics of our patients.... Again you're in the rad onc forum

Ok first of all..let's get some simple things right first. Drug cost is 10% of all healthcare expenditure okay? This includes CMS and private insurance. So drop the whole 23% of CMS budget thing...it has no place in any of this. We cant move on until you get the basics right first.

As for demographics...it doesn't matter. the 10% is the end figure. It includes everything, including CMS (if that is your demographics). To put things in a way that a child would understand, yes it includes your demographics....even then it adds up to just 10%.

 

[CaesarRO]

Ok first of all..let's get some simple things right first. Drug cost is 10% of all healthcare expenditure okay? This includes CMS and private insurance. So drop the whole 23% of CMS budget thing...it has no place in any of this. We cant move on until you get the basics right first.

As for demographics...it doesn't matter. the 10% is the end figure. It includes everything, including CMS (if that is your demographics). To put things in a way that a child would understand, yes it includes your demographics....even then it adds up to just 10%.

Is it clearly stated somewhere that all oncology care (chemo/immunotherapy, etc) would be captured under Retail Prescription Drugs and not under hospital care of an infusion was done impatient or in an infusion center?

I don't know much about how CMS breaks it down but I couldn't find a clear answer after trying to dig around on cms.gov a bit

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[Aphtalyfe]

You're the guy that linked nbcnews...as a physician you should know better than that....rad onc even.

Huh? Growth or not...the end result is that only 10% of healthcare cost is attributed to drugs. The bigger pie is hospital care and physician clinical services. Do you know how to read a pie chart?

I'm baffled that you're an attending...rad onc has declined much I see.

As for demographics...it doesn't matter. the 10% is the end figure. It includes everything, including CMS (if that is your demographics). To put things in a way that a child would understand, yes it includes your demographics....even then it adds up to just 10%.

Is it clearly stated somewhere that all oncology care (chemo/immunotherapy, etc) would be captured under Retail Prescription Drugs and not under hospital care of an infusion was done impatient or in an infusion center?

I don't know much about how CMS breaks it down but I couldn't find a clear answer after trying to dig around on cms.gov a bit

First of all there's no reason to insult people. Secondly, I'm with CaesarRO... I don't know if hospital delivered chemotherapy is included under retail prescription drugs?

Furthermore, within the scope of oncology the breakdown will likely be different. Here's some data from 2013 suggesting that oral vs infusion chemo are separate and together constitute 32% of "National Cancer Expenditure."

The cost of radiation services was not in the abstract, but the presenters also mentioned that radiation services are 2.2 billion. (compared to 9 billion for chemo)

One could argue that perhaps the cost breakdown would be different in a more modern study... but given that the above study was performed in 2019 and they were looking at 2013 suggests that the data is not easily obtained.

 

[Tigerstang]

First of all there's no reason to insult people. Secondly, I'm with CaesarRO... I don't know if hospital delivered chemotherapy is included under retail prescription drugs?

Furthermore, within the scope of oncology the breakdown will likely be different. Here's some data from 2013 suggesting that oral vs infusion chemo are separate and together constitute 32% of "National Cancer Expenditure."

The cost of radiation services was not in the abstract, but the presenters also mentioned that radiation services are 2.2 billion. (compared to 9 billion for chemo)

One could argue that perhaps the cost breakdown would be different in a more modern study... but given that the above study was performed in 2019 and they were looking at 2013 suggests that the data is not easily obtained.

I have a hard time believing radiation is only 2.2B. 21C did annual revenue of nearly 1B before bankruptcy.

 

[Aphtalyfe]

I have a hard time believing radiation is only 2.2B. 21C did annual revenue of nearly 1B before bankruptcy.

The 2.2B is only Medicare. Not sure what the payer mix breakdown was for 21C but I imagine it was skewed towards private insurance.

Also the 2.2B is only for radiation services... Here are some of the other things included in the pie chart:

• Professional fees: $12 billion
  -Office-based systemic therapy: $4.2 billion
  -Surgery: $1.9 billion
  -Radiation: $2.2 billion
  -Other: $3.7 billion
• Inpatient facilities: $6.5 billion
• Outpatient facilities: $1.1 billion
• Oral chemotherapy: $4.7 billion for oral chemotherapy
• Hospital-based chemotherapy: $4.3 billion
• Out-of-pocket expenses: $2.8 billion

 

[thecarbonionangle]

A lot of what we do in our field is to delay the inevitable.

the INEVITABLE is HERE. Sorry folks.

Crony Azar coming for RO.

 

[scarbrtj]

the INEVITABLE is HERE. Sorry folks.

Crony Azar coming for RO.

In the immortal (and detestable! insensitive!) words of Bobby Knight: "If rape is inevitable, relax and enjoy it."

 

[thecarbonionangle]

In the immortal (and detestable! insensitive!) words of Bobby Knight: "If rape is inevitable, relax and enjoy it."

i agree with you, the field is f&&&&&. One may as well just save as much money as one can and enjoy the “ride”

 

[deleted941485]

i agree with you, the field is f&&&&&. One may as well just save as much money as one can and enjoy the “ride”

Zero leadership within the community. No real desire to fight anything govt wants to propose.

 

[OTN]

Zero leadership within the community. No real desire to fight anything govt wants to propose.

Not true. Plenty of radoncs from the largest pp organizations have had meetings with CMS and will continue to fight for radonc. Chris Rose comes to mind off the top of my head- he’s been working on this very hard.

 

[medgator]

Not true. Plenty of radoncs from the largest pp organizations have had meetings with CMS and will continue to fight for radonc. Chris Rose comes to mind off the top of my head- he’s been working on this very hard.

Yup. Back when ASTRO was fighting urorads and opposed things like site neutral payments and bundles because they would hurt academic-based hospital rad onc (even if they did help freestanding rad onc which took the brunt of the cuts for several years).