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Feature Story

Cover Story: Strategy: Cancer: Cost and quality

How cancer reimbursement reform could boost or inhibit drug use

By Erin McCallister, Senior Editor

Early data from the first of several U.S. experiments with cancer payment reform offer the tantalizing possibility that drug companies could actually benefit from schemes designed to reward oncologists for outcomes as well as cost reductions. However, the first pilot - published in July by UnitedHealth Group Inc. - was too small to draw firm conclusions about drug utilization. And not all the other experiments that are under way or in the planning stages include both outcome and cost metrics in their calculations of reimbursement.

The experiments now in progress or on the drawing board take different routes to physician reimbursement reform, such as bundled payments covering drugs and services, or treatment pathways that require adherence to preferred regimens. Those differences aside, they all seek to reduce costs without sacrificing the quality of care.

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