ArticleAmerican Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting2015
Reform of the Buy-and-Bill System for Outpatient Chemotherapy Care Is Inevitable: Perspectives from an Economist, a Realpolitik, and an Oncologist.
Article in American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association Between Reimbursement Incentives and Physician Practice in Oncology: A Systematic Review.JAMA oncology · 2019Pooled it
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- Provider billing margin and cancer treatment selection: population based cohort study.BMJ (Clinical research ed.) · 2025Article
- Commercial Versus Medicaid Insurance and Use of High-Priced Anticancer Treatments.The oncologist · 2024Article
- Greater uptake, an alternative reimbursement methodology needed to realize cost-saving potential of oncology biosimilars in the United States.Journal of managed care & specialty pharmacy · 2021Article
- Financial Burden of Discarded Weight-based Antineoplastic Drugs to Payers and Patients in the Private Insurance Market.JNCI cancer spectrum · 2021Article
- Insights in Public Health: Insurance Coverage for Long-Acting Reversible Contraception Placed in Office: A Buy and Bill Demonstration Project in Hawai'i.Hawai'i journal of health & social welfare · 2020Article
- Article
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- Use of High-Cost Cancer Treatments in Academic and Nonacademic Practice.The oncologist · 2020Article
- Trends in the Price per Median and Mean Life-Year Gained Among Newly Approved Cancer Therapies 1995 to 2017.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2019Article
- The impact of integration on outpatient chemotherapy use and spending in Medicare.Health economics · 2019Article
- Drug Treatment Value in a Changing Oncology Landscape: A Literature and Provider Perspective.Journal of managed care & specialty pharmacy · 2019Review
- Cost-effectiveness of Maintenance Capecitabine and Bevacizumab for Metastatic Colorectal Cancer.JAMA oncology · 2019Article
- Immuno-Oncology Medicines: Policy Implications and Economic Considerations.Innovations in pharmacy · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Treating patients with cancer with infused or injected oncolytics is a core component of outpatient oncology practice. Currently, practices purchase drugs and then bill insurers, colloquially called "buy and bill." Reimbursement for these drugs is the largest source of gross revenue for oncology practices, and as the prices of cancer drugs have grown over time, these purchases have had significant impact on the financial health of practices and pose a risk that jeopardizes the ability of many practices to operate and provide patient care. Medicare Part B spending on drugs is under political scrutiny because of federal spending pressures, and the margin between buy and bill, lowered to 6% by the Medicare Modernization Act and further decreased to 4.3% by sequestration, is a convenient and popular target of budgetary discussions and proposals, scored to save billions of dollars over 10-year budget windows for each percentage-point reduction. Alternatives to the buy-and-bill system have been proposed to include invoice pricing, least costly alternative reimbursement, bundling of drugs into episode-of-care payments, shifting Part B drugs to the Medicare Part D benefit, and revision of the failed Competitive Acquisition Program. This article brings the perspectives of policy makers, health care economists, and providers together to discuss this major challenge in oncology payment reform.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.