CSN Login
Members Online: 15

You are here

Member Resource Library

gdpawel's picture

Selling cancer chemotherapy with concessions creates conflicts of interest for oncologists

Type: 
Article
Description: 

Some Oncologists Look for New Ways To Profit From Cancer Treatments, according to a New York Times article. They examined how limits placed on profits that physicians can make on cancer drugs have left some oncologists "searching for new income," such as by "performing additional treatments that" have "the best reimbursements, whether or not the treatments" benefit the patients. Medicare until 2005 paid a markup of 20% to 100% for many cancer drugs, along with injectable treatments for arthritis and other diseases.

In 2005, Congress changed the reimbursement system to pay physicians 6% more than the average price for a given treatment. The reduction in reimbursements "did not reduce overall federal spending on cancer care," which has increased slightly in the last two years, and the difference in spending "mostly represented profit that doctors had made on the drugs," the Times reports. However, cancer doctors say the "change did nothing to reduce a larger problem in cancer treatment," according to the Times.

The decrease in payments has made it difficult for smaller practices to break even on cancer drug purchases because the practices often do not buy enough of any drug to receive rebates or discounts from drug manufacturers. Some oncologists have attempted to increase profits by "performing chemotherapy more often or installing multimillion-dollar imaging machines where they profit when their patients receive diagnostic scans" and by "putting new pressure on cancer patients to make out-of-pocket drug copayments," according to the Times.

The situation "offers a vivid example of how difficult it may be to rein in the nation's runaway health care spending without fundamentally changing the way doctors are paid," the Times reports. Robert Geller, a former oncologist and senior medical director at Alexion Pharmaceuticals, said oncologists likely will continue to find ways to profit from Medicare as long as they are paid by procedure and not for time spent with patients.

In related news, the Times examines how before the change to Medicare reimbursements for cancer treatments, pharmaceutical companies "sometimes calculated to the penny the profits that doctors could make from their drugs" and sales representatives from the companies "shared those profit estimates with doctors and their staffs," according to industry documents that have become public in a federal civil lawsuit against drug makers. The lawsuit, filed by cancer patients and health insurers, alleges that marketing practices of drug companies caused them to be overcharged for oncology medicines because list prices for the drugs were higher than the actual cost of the drugs for physicians.

Source: 
Healthy Skepticism
Author/Speaker/Performer: 
Gregory D. Pawelski
NaturalChemo's picture

Non-poisonous Chemotherapy & More - how we fought breast cancer!

Type: 
Book
Description: 

A no-nonsense practical approach on utilizing science-based complementary alternative medicine (CAM) for cancer. Discover non-poisonous chemotherapy, non-toxic plant-based therapy for ER positive, HER2 positive and immunotherapy. Discover how we're fighting our breast cancer successfully WITHOUT any side effects!

Source: 
Health Seminars, Inc.
Author/Speaker/Performer: 
Curtis Eakins, N.D. & Paula Eakins, M.S.
Publish date: 
April, 2007
btcat's picture

yummy healthy food recipes

Type: 
Web site
Description: 

There was an aricle about proffessional chef Rebecca Katz,who started this website and wrote a cookbook, "One Bite at a Time" of yummy healthy healing recipes,in this months issue \. She was inspired to do this when cooking for her dad, who was dealing with cancer. See the May, 2007 issue of Guideposts Magazine to read more about her and her story.

Ease Patients' Suffering with Access to Medical Marijuana: A Cancer Survivor's Story

Type: 
Article
Description: 

Connecticut’s Compassionate Use medical marijuana bill will be heard in its next committee tomorrow–Tuesday. So, we need to keep the same momentum going that pushed this through the General Law Committee like last week for the Public Health Committee for tomorrow’s hearing!

A phone call can also make a big impression on legislators. You can call the Public Health Committee before 9 a.m. on Tuesday to express your support for HB 6715. The number is 860-240-0560.

For more info on the bill, here’s a piece that I worked with the Drug Policy Alliance on, advocating for the passage of the CT’s Compassionate Use Bill on Huffington Post today.
http://www.huffingtonpost.com/cole-krawitz/ease-patients-suffering-_b_47309.html

You can also take action here:

http://actioncenter.drugpolicy.org/action/index.asp?step=2&item=31732&MS=CTmmj043007-ip

Source: 
Huffington Post
Author/Speaker/Performer: 
Cole Krawitz
gdpawel's picture

Medicare Contractor Establishes Reimbursement Coverage Policy for Cell Culture Assay Tests

Type: 
Article
Description: 

National Heritage Insurance Company (NHIC), the contractor that administers Medicare programs in California, has established a positive coverage policy for Cell Culture Assay Tests known as Chemosensitivity (Resistance) Testing or Oncologic In Vitro Chemoresponse Assays for a tumor specimen from a Medicare patient obtained anywhere within the United States, but submitted for testing by one of the approved laboratories located within Southern California. Medicare bills for this testing are billed through NHIC because the test is conducted by the approved laboratories in California.

This pre-test can help see what treatments have the best opportunity of being successful for "high" risk cancer patients. The test measures the response of "live" tumor cells to drug exposure. Following this exposure, the assays measure both cell metabolism and cell morphology (Functional Profiling). The integrated effect of the drugs on the whole cell, resulting in a cellular response to the drug, measuring the interaction of the entire genome. Assays based on "cell-death" occur in the entire population of tumor cells.

This cell culture assay technology has been clinically validated for the selection of optimal chemotherapy regimens for individual patients. It is a laboratory analysis based on tumor tissue profiling that uses "fresh" human tumor biopsy or surgical specimen to determine which drugs or combinations of chemotherapeutic agents have the highest likelihood of response for individual cancer patients.

Following the collection of "fresh" tumor cells obtained from surgery or tru-cut needle biopsies, a cell culture assay is performed on the tumor sample to measure drug activity (sensitivity and resistance). This will pinpoint which drug(s) are most effective. Tissue, blood, bone marrow, and ascites and pleural effusions are possibilities, providing tumor cells are present. At least one gram of fresh tissue is needed to perform the tests, and a special kit is obtained in advance from the lab. The treatment program developed through this approach is known as assay-directed therapy.

Individualized assay-directed therapy is based on the premise that each patient's cancer cells are unique and therefore will respond differently to a given treatment. This is in stark contrast to standard or empiric therapy, which chemotherapy for a specific patient is based on average population studies from prior clinical trials.

The decision had been made that the assay is a perfectly appropriate medical service, worthy of coverage on a non-investigational basis. What is of particular significance is that they abandoned the artificial distinction between "resistance" testing and "sensitivity" testing and are providing coverage for the whole FDA-approved kit. Drug "sensitivity" testing is merely a point a little farther along on the very same continuum which "resistance" testing resides.

Cell cuture assay tests based on "cell-death" have proven very effective in identifying novel treatment combinations for a variety of cancers. The value of cell-death assays is that they can and do accurately predict clinical outcomes and define novel chemotherapeutic synergies. It can help see what treatments will not have the best opportunity of being successful (resistant) and identify drugs that have the best opportunity of being successful (sensitive).

The current clinical applications of in vitro chemosensitivity testing is ever more important with the influx of new "targeted" therapies. Given the technical and conceptual advantages of "functional profiling" of cell culture assays together with their performance and the modest efficacy for therapy prediction on analysis of genome expression, there is reason for renewed interest in these assays for optimized use of medical treatment of malignant disease.

The payment provided will be sufficiently realistic that all Medicare patients for whom this testing is indicated will be able to get it with only the routine 20% co-payment, as Medi-gap insurance secondaries are mandated to provide payment for co-pays for Medicare-approved services.

The coverage became effective for claims for services performed on or after February 19, 2007. The decision is posted at:

http://www.medicarenhic.com/cal_prov/articles/chemoassaytest_0107.htm

NHIC Medicare Services reimburses qualified laboratories in Southern California for cell culture assay tests on a Medicare patient anywhere in the United States.

Likewise, Highmark Medicare Services reimburses a qualified laboratory in Pennsylvania for cell culture assay tests on a Medicare patient anywhere in the United States.

NHIC has jurisdiction over Southern California, so that is who gets billed when the laboratory is located in California.

Highmark has jurisdiction over laboratories in Pennsylvania, so that is who gets billed when the laboratory is located in Pennsylvania.

The coverage decision is posted at:

http://www.highmarkmedicareservices.com/bulletins/partb/news06132007.html

Source: 
Human Tumor Assay Journal
Author/Speaker/Performer: 
Gregory D. Pawelski
gdpawel's picture

Selling cancer chemotherapy with concessions creates conflicts of interest for oncologists

Type: 
Web site
Description: 

The shift in the United States, more than 20 years ago, from the institution-based, inpatient setting to community-based, ambulatory sites for treating the majority of the nation's cancer patients has prompted in large part additional costs to the government and Medicare beneficiaries. The Chemotherapy Concession gave oncologists the financial incentive to select certain forms of chemotherapy over others because they receive higher reimbursement.

gdpawel's picture

Cure: Scientific, Social, and Organizational Requirements for the Specific Cure of Cancer

Type: 
Book
Description: 

Dr. Arny Glazier, a cancer researcher, feels that deeply held assumptions, theories and dogmas about cancer are not tenable given the fundamental evolutionary nature of the disease. He has published a book, "Cure: Scientific, Social, and Organizational Requirements for the Specific Cure of Cancer." The book, which was written for both scientists and non-scientists, explains tumor cell evolution and its logical implications.

He feels that cancer is about the properties of evolutionary populations of cells. He believes that the diverse, evolutionary nature of cancer implies that the required target for the consistent and specific cure or control of cancer is "the set of all malignant cells that could evolve."

To him, the consistent and specific cure or control of cancer will require developing a set of drugs, given in combination, targeted to patterns of normal cellular machinery related to proliferation and invasiveness. These requirements define a rational, practical strategy to develop curative therapy for all forms of solid cancer. A sufficient number of independent methods of cell killing must be employed so that it is too improbable for a cancer cell to evolve that can escape death or inactivation. It must examine every cell in the body and must do so for a prolonged period of time.

Although his book may argue against the notion of personalized therapy tailored to the individual's cancer cells, given the current state of the art, in vitro drug sensitivity testing could be of significant clinical value to his premise. If an in vitro drug resistance test can demonstrate the presence of cancer cells that are resistant to a drug combination, then it is rational to use alternative therapy. If an in vitro drug sensitivity test has the ability to demonstrate which drug combinations would be synergistic to cell death in all cancer cells present, then it is rational to use the drugs indicated in the test.

Cell culture assays, using the whole cell profiling method, can assess the activity of a drug upon combined effect of all cellular process, using combined metabolic (cell metabolism) and morphologic (structure) endpoints, at the cell population level, measuring the interaction of the entire genome.

I feel the book is well worth the reading for anyone wanting a better understanding about the fight against cancer. It is available at: http://www.lulu.com/content/276115

Source: 
LuLu
Author/Speaker/Performer: 
Arnold Glazier, M.D.
Publish date: 
June 28, 2006
azcard's picture

Mr. Bloh from H&R Block - Letter and Book

Type: 
Web site
Description: 

Read the letter. Offer of a book there for free. The book has very good information!

Good for someone just starting this journey we call cancer.

azcard's picture

Leionmyosarcoma Web Site

Type: 
Web site
Description: 

Was my starting point for research.

Climb Back from Cancer - Introducing The 10 Tools of Triumph for Survivors and Caregivers

Type: 
Book
Description: 

The first book in the proposed "Climb Back from Cancer Collection", this is both a gripping true adventure story and a powerful tool kit for triumph. At the age of 42, international bestselling author and Mt. Everest climber and summiteer, Alan Hobson, beleived scaling the world's tallest peak would be the biggest challenge he would face in his life. Over a decade, he had endured three gruelling expeditions to Everest before finally standing on top of his third attempt. Then he had turned his ambition to becoming the best adventure speaker in the world. But three years after Everest, he came face to face with an even bigger mountain: he was diagnosed with acute leukemia, a cancer of the blood, and given less than a year to live. With the help of his fiancee, Cecilia, he not only survived, but thrived, and the couple emerged all the stronger from their shared trial. Climb Back from Cancer is their inspiring account of commitment, teamwork and triumph. The story offers not only a living example of how to climb back from cancer, but demonstrates how to transform adversity into opportunity. It includes The 10 Tools of Triumph for Survivors and Caregivers - what the couple considers to be the key psychological skills required to survive life-threatening illness and thive beyond it.

Source: 
Self Published
Author/Speaker/Performer: 
Alan Hobson and Cecilia Hobson
Publish date: 
2004

Pages