Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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How is your Myeloma Specialist Paid?
Do you know how your myeloma specialist is paid? Do you care if they make money based on how much chemotherapy they prescribe? If your oncologist uses a “fee-for-service” model, According to research approximately 25% of oncology practices are some form of fee-for-service aka their practice charges for each and every service.
- You/your insurance is charged for every test, therapy, etc.
- You/your insurance is charged for expensive chemo regimen
Charged for every test, therapy, service-
Your onc. has an incentive to prescribe a triplet therapy when a doublet therapy may be needed. The standard-of-care therapy plan for “elderly” MM patients is Revlimid and dex. Many elderly MM patients are prescribed more regimens, more toxicity than is FDA approved.
Charged for expensive chemo regimens-
Why does this affect me? For example, zometa (bisphophonate for bone strength) is relatively inexpensive. Denosumab, also for bone strength, is about twice as expensive. You may have a 20% co-pay for this standard-of-care therapy- $200.00 vs. $400.00. If this therapy is monthly or even quarterly, your co-pays can add up.
If you have kidney involvement, denosumab may be safer for your kidneys than zometa.
The treatment math gets really complicated when we talk about an autologous stem cell transplant.
Fee-for-Service Medical Payment as a Public Health Threat
Please don’t misunderstand me. I believe that oncologists are smart, well-educated people with a difficult job. At the same time, I believe that managing MM, among other things, is incredibly expensive. Fee-for-service is a problem.
I am a long-term MM survivor. Email me at David.PeopleBeatingCancer@gmail.com with your questions about managing your MM.
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Are Oncologists’ Financial Incentives Aligned With Quality Care?
“…Compared with medical oncologists who were paid a fixed salary, those who were in fee-for-service (FFS) practices or who were paid a salary with a productivity incentive were more likely to anticipate greater income if they administered chemotherapy (odds ratio, 7.05 and 7.52, respectively; both P < .001). Similar associations were found for growth factor administration…
A Call to Eliminate ‘Chemotherapy Concession’
A new study confirms that financial incentives exist for some US oncologists in the prescribing of chemotherapy and growth factors for treatment-related anemia.
These potential “inducements” are not widespread, existing for only about 25% of 480 medical oncologists surveyed, and are mostly among fee-for-service clinicians or those with financial incentives in their salary structure…
Trends in Industry Payments to Medical Oncologists in the United States Since the Inception of the Open Payments Program, 2014 to 2019
Importance Given the potential for undue influence of industry-physician payments on oncology care, it is important to understand how a national transparency program may be associated with financial interactions between industry and medical oncologists.
Objective To identify trends in industry payments to medical oncologists from 2014 to 2019 and determine if the implementation of the Open Payments program is associated with changes in the frequency or value of payments or any shift in the nature of industry-oncologist financial interactions.
Results In 2014 to 2019, there were 15 585 medical oncologists who received a total of 2.2 million industry payments with a total value of $509 million.
The absolute number of oncologists receiving payments decreased from 10 498 in 2014 to 8918 in 2019 (−15.1%). The annual per-physician payment value decreased among those receiving less than $10 000 in aggregate by −3.2% yearly (95% CI, −4.1% to −2.3%; P < .001), but increased for those receiving more than $10 000.
Payments increased for consulting (13.7%; 95% CI, 12.4%-15.0%; P < .001) and for entertainment, meals, travel or lodging, and gifts (0.8%; 95% CI, 0.1%-1.5%; P = .03).
Conclusions and Relevance The number of medical oncologists accepting industry payments has decreased; however, high-value industry payments have been consolidated in a relatively small number of medical oncologists accepting higher payment values over time. The nature of payments has shifted toward consulting. These findings highlight the limitations of transparency without accountability…”
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