Medicare Cuts May Have Spurred Drop in Prostate Cancer
FRIDAY, Dec. 3 (HealthDay News) -- Use of androgen suppression
therapy for low-risk prostate cancer fell after doctors starting
receiving lower Medicare payments for the treatment, but use of the
treatment for patients with metastatic prostate cancer stayed
steady, a new study shows.
The findings, published online Dec. 3 in the
Journal of the National Cancer Institute, suggest the payment cuts may have reduced over-treatment of low-risk prostate cancer, the researchers said.
Between 1991 and 1999, the use of the therapy for prostate
cancer increased more than threefold among patients with metastatic
prostate cancer (cancer that has spread) and low-risk prostate
cancer, even though the treatment has not been shown to improve
survival in patients with low-risk disease.
When Medicare physician reimbursements for androgen therapy were
reduced by 64 percent between 2004 and 2005, use of the therapy for
men with low-risk prostate cancer fell by 40 percent while there
was no statistically significant change among men with metastatic
prostate cancer, the study found.
The researchers looked at factors other than Medicare payment
cuts that could account for the findings, such as growing awareness
of the therapy's side effects and increasing use of longer-acting
However, they concluded that the decline in use of androgen
therapy for low-risk prostate cancer patients "likely represents a
real effect of reimbursement change and not physician awareness of
clinical evidence," wrote Dr. Sean P. Elliott, of the University of
Minnesota, and colleagues in a news release from the journal.
The American Urological Association has more about
hormone therapy for prostate cancer.
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