Year one evaluation of regional pay for quality (P4Q) oncology program.
2010; Lippincott Williams & Wilkins; Volume: 28; Issue: 15_suppl Linguagem: Inglês
10.1200/jco.2010.28.15_suppl.6013
ISSN1527-7755
AutoresJane Scott, Wan Keung Wong, Timothy M. Olson, Barry Fortner,
Tópico(s)Pharmaceutical Economics and Policy
Resumo6013 Background: Oncology clinical pathways are common in current practice. However, little information is available evaluating the cost savings of enacting pathways. This study evaluates the potential cost savings of a payer-based P4Q program employing clinical pathways. Methods: A P4Q program was enacted in five northeastern states, USA, beginning August 1, 2008, and consisted of physician generated treatment (i.e., breast, lung, and colon-rectal cancer) and supportive care pathways (i.e., colony-stimulating factors, erythropoietin stimulating agents, and antiemetics). Feedback was provided to participants regarding compliance, and increased fee schedules in year 1 were adjusted in year 2 contingent on compliance in year 1. Savings analysis used the difference in participating and nonparticipating practice growth rates from the year prior to the program (pre) to the first year of the program (Yr 1) to estimate yearly savings for the participating practices. Results: 57 participating practices (176 physicians, 10,432 patients) and 43 nonparticipating practices (194 physicians, 14,137 patients) contributed to the analysis. The pre to Yr 1 growth rate in cost was 7.7%, -3.0%, and 2.8% for antineoplastic drugs, supportive care drugs, and nondrug services respectively in the participating practices and 15.4%, 2.4%, and 19.0% in the nonparticipating practices. Estimated savings were calculated for antineoplastic drugs ($6,766,500), supportive care drugs ($1,427,108), nondrug services ($4,039,359), and total ($12,232,967). When the costs of the Yr 1 fee schedule increase for participating practices were factored out, the total savings were estimated at $8,585,148. Conclusions: This study suggests pathway programs may reduce the costs of cancer care by reducing the growth rate of both drug and nondrug expenses. Further evaluations should explore indications of how these costs were reduced (e.g., drug selection) and consider clinical outcomes and compliance in relation to costs savings. The primary limitations of the study derive from the nonexperimental research design which allows confounds to causal inference. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration P4 Healthcare P4 Healthcare
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