You have reached your limit of free articles this month.

Enjoy unlimited access to

Starting at just 99¢ for 8 weeks.


  • ePAPER

You have read of premium articles.

Get unlimited access to all of our breaking news, in-depth coverage and interactive features. Starting at just 99c for 8 weeks.


Welcome to

Your source for Clark and Champaign counties’ hometown news. All readers have free access to a limited number of stories every month.

If you are a News-Sun subscriber, please take a moment to login for unlimited access.

breaking news

Springfield police open death investigation after woman’s body found

Budget cuts limit cancer treatment options

Cancer clinics across southwest Ohio are struggling to provide drug therapies for many of their patients as a result of Medicare cuts in reimbursements for cancer drugs included in the government’s spending cuts known as sequestration.

The 2 percent cut in drug reimbursements not only applies to the average cost of the drugs but also the cost to store, handle and administer the drugs. That can make treatments cost-prohibitive for many private practices, which may be forced to send patients to hospitals or other skilled nursing facilities where treatments typically are more expensive.

“Our greatest concern is that when care is shifted from a private office into a hospital setting it causes a substantial increase in the overall cost of care,” said Dr. Charles Bane, an oncologist at the Greater Dayton Cancer Center. “Because medications are often more expensive when acquired by a hospital, the (insurance) co-pay portion for patients is often higher.”

Hospitals routinely mark up the prices of cancer drugs to cover facility costs and to make up for losses in other services they provide. The cost differential can be substantial when compared to drug treatments administered at a doctor’s office or clinic, Bane said.

“Chemotherapy treatments vary tremendously depending on the type of cancer we’re treating and the type of treatment the patient is receiving,” he said. “But costs ranging in the many thousands of dollars a month for chemotherapy are not unusual.”

Hospitals costs more

A recent study from the Washington-based consulting firm Avalere Health found average chemotherapy costs per episode — or the length of treatment — were $28,200 in a doctor’s office versus $35,000 in a hospital in 2012, a 24 percent difference.

The associated increase in out-of-pocket costs for cancer patients seeking treatment in hospitals can easily reach thousands of dollars a year, Bane said. That would have a disproportionate impact on those living on fixed incomes who are covered by Medicare — the government health insurance program for seniors and the disabled.

Joyce Kirby of Centerville is a breast cancer survivor who is among the estimated 85 percent of Ohio Medicare beneficiaries who are 65 or older. She has private supplemental insurance to cover any gap in Medicare coverage for the chemotherapy treatments she began receiving twice a week at the Dayton Cancer Center after undergoing a single mastectomy in February.

Still, she laments the government cuts that she fears will force many cancer clinics to close, which would displace Medicare beneficiaries at a time they’re fighting for their lives.

“If you don’t have the kind of insurance I have, it could be a life-and-death situation,” Kirby said. “To think that our government could come in here and say that we’re going to make it impossible for our doctors to keep all of their staff and keep their clinics open just doesn’t make sense to me.

“We’re blessed to live in this country,” she said. “But I fear we’re in danger of becoming a Third World country with lines around one building because they’ve closed all the other facilities.”

According to a recent survey from the American Society of Clinical Oncologists, almost a quarter of the 500 members surveyed indicated prolonged sequester cuts would force them to shut their doors.

Twenty-two percent of survey respondents said they had already closed satellite clinics. In addition, 50 percent of respondents said they had already begun to send Medicare patients to hospitals for chemotherapy, and nearly three quarters (74 percent) of respondents said they were having difficulty paying for chemotherapy drugs.

The survey was conducted from April 23 to May 1, less than a month after the sequester cuts took effect April 1.

Monitoring the impact

So far, most Dayton-area practices have continued to provide drug therapies for their Medicare patients despite the sequester cuts, said Robert Baird, chief executive of the Dayton Physicians Network, the largest oncology group in the area with 37 doctors and 15 locations stretching from Cincinnati to Troy.

“The way we’re handling it in our network right now is every month we’re monitoring the impact on certain medications, the ones that are underwater,” he said, referring to those cancer drugs for which the Medicare reimbursement is below cost.

“In some instances, we’ve been successful in finding (charitable) foundation support and other outside support to help with costs. And we’ve delayed a lot of the non-essential capital expenses and delayed hiring or replacing staff.”

Such cost-cutting measures are unsustainable in the long run, Baird said.

“We either have to absorb those increased costs for medications … or we can send them (cancer patients) to an alternative site for treatment like a hospital,” he said.

While referring patients to hospitals may help in the near term, it probably won’t be a viable long-term solution, Baird said.

“If we were to send even a third of our patients and transfer their care to a hospital setting, they couldn’t handle it,” he said. “They don’t have the staff; they don’t have the space.”

Mark Shaker, senior vice president at Premier Health Partners, agreed.

“If they closed Greater Dayton Cancer Center that would be a strain on our community, for sure,” said Shaker, who keeps close tabs on the hospital network’s outpatient infusion centers. “I don’t have capacity for that many patients. But we haven’t seen a huge influx yet, and I don’t think that’s imminent.”

Reader Comments ...

Next Up in Health

In search of an indestructible dog toy
In search of an indestructible dog toy

If my family was ever in an accident and the “Jaws of Life” were required, we’re all set. Teddy, our sweet, tummy-rub-loving Lab could handle the job. His jaws seem to be made of steel. RELATED » Teddy finds his voice The pooch can shred most toys in a matter of minutes. It doesn’t matter if the toy is soft and squishy...
This ‘Hunger Games’ exhibit is SO worth the drive
This ‘Hunger Games’ exhibit is SO worth the drive

If you were looking for an excuse for a mini-getaway that’s less than 3 hours away, your moment has come. “Hunger Games: The Exhibition” is on display now at The Frazier History Museum in Louisville, Kentucky through September 10, 2017. Louisville is about 2.5 hours from Dayton’s center, so it can easily be a day or weekend...
Plant a tree in honor of Arbor Day
Plant a tree in honor of Arbor Day

Given that yesterday was Arbor Day, why not plant a tree this weekend? Garden centers are stock-full of great selections for your landscape and have lots of people on hand to help you pick out the perfect tree. If you decide to plant a tree, make sure you plant it properly for longevity. One of the biggest mistakes that I see is that people plant trees...
Humane society, Dayton firefighters rescue cat stuck in pipe
Humane society, Dayton firefighters rescue cat stuck in pipe

It took hours and special equipment for rescuers to free a cat today with its head stuck in a pipe embedded in a cement block in Dayton. The Humane Society of Greater Dayton responded to a report the cat had been stuck for hours. When they arrived, the cat had worn down its nails clenching at the ground trying to escape. The pipe was too thick to easily...
Hershey getting health conscious, cutting chocolate calories by 2022
Hershey getting health conscious, cutting chocolate calories by 2022

The Hershey Co. is promising to make major changes in the calorie count of some of its chocolate snacks. The company announced last week that it wants to cut the calories in 50 percent of its standard and king-size confectionary snacks by 2022, and include easier-to-read nutrition labels on the front of 100 percent of its standard and king-size packaging...
More Stories