Reimbursements Sway Oncologists' Drug Choices | |||
AlkalizeForHealth
"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease." Australian study shows chemotherapy is ineffective: 1, 2.
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Received from Gregory D. Pawelski March 16, 2006. Reimbursements Sway Oncologists' Drug Choices A joint Michigan/Harvard study that confirms
medical oncologists choose cancer chemotherapy based on how much
money the chemotherapy earns the medical oncologist. What was interesting about the "Patterns of Care" study was that it is contemporary, after the Medicare reform. It shows that the Medicare reforms haven't solved the problem. It's not that all oncologists are bad people. It's just an impossible conflict of interest, it's the system which is rotten. The solution is to change the system. So far, Medicare reform hasn't achieved that. Two scientific "evidence-based" studies give a dose of reality. It was very personal situation for me. I didn't need these two scientific "evidence-based" studies to tell me that my wife's oncologists had the incentive to prescribe a $15,000 taxol/carboplatin combination regimen to a patient who was platinum-resistant, instead of a $1,500 alkylating agent regimen the patient had before. Chlorambucil (Leukeran) was the postoperative chemotherapy my wife had for her original ovarian cancer in 1972. It was the slowest acting and least toxic of the alkylating agents (well tolerated oral drugs). Depression of the immune system was slow and reversible, allowing it to regenerate and contribute to recovery. A malfunctioning immune system can fail to stop the growth of cancer cells. She went twenty-four years before ever experiencing a recurrence in 1996. The postoperative chemotherapy she received from the oncologists at our so-called community cancer center for her recurrent ovarian cancer was taxol/carboplatin. It is commonplace to give the same treatment to a recurrence (after six months) as was given for the original tumor (in my wife's case, chlorambucil). If it worked the first time, it sure has a very good chance of working again. Patients who develop recurrent ovarian cancer more than six months after first-line chemotherapy (in my wife's case, 24 years), can experience another remission following treatment with the identical first-line chemotherapy that was previously used (in her case, Chlorambucil). But again, I didn't need two scientific studies to tell me why they did or didn't do. This is just the scientific "proof." The information is much more important because the "Patterns of Care" shows that the Medicare reforms are still not working. It still is an impossible conflict of interest. The last time Congress helped cancer doctors, Committee Chairman Senator Chuck Grassley found out that the value of the $300 million-a-year demonstration project for oncology to report on a cancer patient's level of nausea, vomiting, pain and fatigue was for nothing. Providers were being paid an additional $130 per infusional-chemotherapy recipient per treatment day to simply forward data that had already been collected. This year, Congress is being hoodwinked into some other financial incentive to reimburse oncologists that report whether their treatment adheres to practice guidelines published by either NCCN or ASCO. It's called the "Community Cancer Care Preservation Act (S2340), just introduced by Senator Arlen Spector. I would encourage cancer advocates to write their U.S. Senators and ask them to delete these harmful aspects of the proposed bill. They need to be eliminated, not continued. And continue exposing these two studies, so as many cancer patients as possible will understand. Gregory D. Pawelski
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