Medicare Law Has Little Impact On The Cost Of Chemotherapy

Chemotherapy in general

Chemotherapy is one of the many types of methods that are used to treat cancer. Depending on the particular type of cancer, its level of progression and other factors, this method has proven to be one of the most effective ones in reversing the effects of a tumor in the body by killing the cancer cells directly.

Although effective, chemotherapy has been described as one of the most expensive forms of treatment for cancer. The type and amount of drugs that are used in the course of the treatment usually amount to a substantial amount. Yet cancer is a disease whose adverse effect on the population is well documented.

Therefore, the need to develop programs that reduce the cost of undergoing chemotherapy has dominated academic and public debate for long. That is why the government developed a comprehensive medical law to help in bringing down the costs of chemotherapy.

How the chemotherapy costs are covered in the Medicare law

Generally, the law seeks to reduce the financial burden of undergoing chemotherapy by following four main strategies designated as plan A, B, C and D. every one of these plans covers different aspects of the overall cost and vary from the rest in terms of the amounts that are covered for every component of the treatment.


For Plan A, cover for the costs of chemotherapy is extended to patients who are admitted to a hospital. The hospitals that are taken into consideration when this plan is applied are the usual public ones as well as the specialized medical facilities that offer cancer treatment and care to patients. This plan is different from Plan C under which care is extended to outpatient clients only.

For Plan C, all the provisions under plan A and B are included but there are other additional advantages that are provided to individuals. What this implies is that a person who is subscribed to Plan C of the Medicare policy is able to enjoy a range of advantages in terms of reduced costs for undergoing chemotherapy. The advantages apply to any hospital or cancer treatment facility.

Then there is the last plan which is referred to as Plan D. under this plan, an individual is able to enjoy reductions in the cost of buying the drugs that are used for chemotherapy. Although this plan covers all the prescription drugs that one may use in the course of undergoing chemotherapy, it is worth noting that the plan only covers outpatient services. This implies that it is not applicable to the drugs used by inpatients.

How the Medicare law sought to reduce the cost of chemotherapy

Passed back in 2003 and 2005, the Medicare law sought to help reduce the costs of chemotherapy for cancer patients. Generally, the law pursued several approaches. The first one was reducing the usage of highly priced drugs for treating cancer. since a large portion of the costs of undergoing chemotherapy are consumed by buying highly priced drugs, the law sought to reverse this by introducing special reimbursements to clinics that charge clients a fee for their service. The idea was that by reimbursing such service providers, the manner in which they recommend drugs for cancer treatment would be controlled.

Therefore, under the legislation, different types of drugs were accorded different levels of reimbursements to the service providers. The law sought to reduce the high dependence that service providers show on such expensive drugs by reducing the amount of reimbursements that is offered to them. This way, it was thought that service providers would find selling such drugs not as profitable as it was before and consequently reduce the frequency with which they prescribe them to their patients.

Impact of the Medicare law on the cost of chemotherapy

Although the Medicare law that was developed and passed sought to bring down the costs of chemotherapy to individuals who are registered in the plan, this has not been the case. So far, things have turned out quite differently from what the drafters of the policy and laws intended. Increasing academic opinion indicates that the policy itself has failed, apart from the relevant legislations that were passed as a way of implementing it. There are several ways in which this failure in the law and policy has been seen. These are described in the sections that follow.

First, it has now become obvious that the law has failed to limit the extent to which doctors prescribe the most expensive drugs to patients. When developed, the law sought to limit the number of highly expensive drugs that doctors recommend to their patients by reducing the amount of reimbursements that are offered to doctors on such drugs. The idea was that by reducing the amount of reimbursement that is offered to doctors on such drugs, doctors would definitely avoid recommending them to their patients because of the financial implications involved.

However, this has not been the case. Over the course of time, doctors have continued to prescribe to their patients the most expensive drugs. This only means one thing; that the policy has failed to achieve this objective.

Another way that the Medicare law can be said to have failed in achieving its objectives can be seen in the relationship between the overall cost and rate of cancer. Research studies have indicated that cancer rates have fallen slightly over the years. However, the overall cost of cancer has been rising over the years. Yet the overriding objective of the Medicare law was to reduce the costs of chemotherapy. What this implies is that the law has failed to curb the rising costs of chemotherapy for patients and other stakeholders in the healthcare industry.

It is because of this situation that the need for comprehensive cancer treatment and management is on the rise. AWAREmed Health and Wellness Resource Center in Myrtle Beach, South Carolina is a leading institution in provision of integrated cancer treatment therapies. We believe that an integrated approach has an important role to play in overall cancer treatment and management practices.

Medicare Law Has Little Impact On The Cost Of Chemotherapy