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.

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

Tuna, star of the Amazing Acro-Cats, dies of cancer
Tuna, star of the Amazing Acro-Cats, dies of cancer

The cowbell won't sound quite the same now that Tuna, the star of the Amazing Acro-Cats cat circus, has died.Happy Cats Haven posted the news Friday on its Facebook page: "To all our fans of Tuna and The Rock Cats and the Amazing Acro-Cats, it's with many tears that we let you know that Samantha Martin's star kitty Tuna crossed the Rainbow Bridge...
7 small changes that will have a big impact
7 small changes that will have a big impact

It’s only a few weeks into 2017, but you’ve already come to an uncomfortable and familiar realization. New Year’s resolutions result in more guilt and depression than achievement. Forget about the big aspirations for a transformational do-over. They don’t work. How about making some small changes today that eventually can have...
Let’s have a cheer for the Amherst Hamsters
Let’s have a cheer for the Amherst Hamsters

Amherst, a tiny college of 1,795 really smart scholars in Massachusetts, made news last year when the board of trustees voted to drop Lord Jeffs as its athletic teams’ unofficial mascot. Lord Jeffery Amherst, historians discovered, was not necessarily a nice person. The 18th century British general reportedly once suggested giving smallpox-infested...
Stark numbers show heroin’s local grip
Stark numbers show heroin’s local grip

An average of seven Montgomery County residents a day were treated for drug overdoses by emergency departments in 2016, and one person alone made eight trips to the ER. Eleven people were treated twice in the same day for overdoses. The stark figures — amassed largely due to a devastating heroin epidemic — are found in a new Public Health...
After a cesarean, some women can have a vaginal birth

Premier HealthNet is one of the largest groups of pediatrics, family medicine, internal medicine, and urgent care practices in southwest Ohio. For more information, go online to Birthing a baby can be a long, painful process, but for many women the experience fulfills a deep emotional longing as a new mom. A vaginal birth...
More Stories