U.S. spending on cancer therapies has risen sharply in recent years. Researchers from Brigham and Women’s Hospital analyzed data on drug pricing from 61 National Cancer Institute-designated cancer centers to determine how much U.S. hospitals mark up the price of cancer therapies for patients with private health insurance. The team conducted a cross-sectional study of the 25 most common injectable or infusible cancer therapies. The researchers report more than half of cancer centers did not publicly disclose payer-specific prices, despite federal regulation requirements. Among those that did, many substantially marked up drug prices for patients with private insurance, and markups ranged from approximately 120 percent to 630 percent of the cost for the hospital to acquire the drug. They also found that negotiated prices varied between payers even at the same cancer center.
“Our study indicates that there is both significant markup and variation in negotiated prices for cancer therapies. Policy changes may be helpful to prevent excessive hospital price markups and reduce the financial burden of cancer treatment for patients,” said corresponding author Roy Xiao, MD, MS, a resident in the Harvard Medical School/Mass Eye and Ear/Mass General Brigham Residency Program in Otolaryngology–Head & Neck Surgery.
Read more in JAMA Internal Medicine.
Journal
JAMA Internal Medicine
Method of Research
Observational study
Subject of Research
People
Article Title
Hospital-Administered Cancer Therapy Prices for Patients With Private Health Insurance
Article Publication Date
18-Apr-2022
COI Statement
Dr Ross reported receiving grants from the US Food and Drug Administration, Johnson & Johnson, Medical Devices Innovation Consortium, the Association for Healthcare Research and Quality, National Institutes of Health National Heart, Lung, and Blood Institute, and Laura and John Arnold Foundation outside the submitted work; and Dr Ross is an expert witness at the request of Relator's attorneys, the Greene Law Firm, in a qui tam suit alleging violations of the False Claims Act and Anti-Kickback Statute against Biogen Inc. Dr Gross reported receiving grants from the National Comprehensive Cancer Network (AstraZeneca), Johnson & Johnson support for new models of clinical trial data sharing, and personal fees from Genentech Support for conducting studies with their group of molecular profiling use in real-world practice outside the submitted work. Dr Dusetzina reported receiving grants from the Commonwealth Fund, The Leukemia & Lymphoma Society, Arnold Ventures, and RobertWood Johnson Foundation; honorarium fromWest Health and Institute for Clinical and Economic Review for advisory roles; consulting fees from the National Academy of State Health Policy outside the submitted work; and compensation by the Medicare Payment Advisory Commission as a government employee. Dr McWilliams reported receiving grants from Arnold Ventures during the conduct of the study; consultant fees from Blue Cross Blue Shield of North Carolina; and served as a paid senior adviser to the Center for Medicare and Medicaid Innovation. Dr Rathi reported employment by F-Prime Capital to identify and qualify investment opportunities in early-stage life sciences companies. No other disclosures were reported.