Cancer care administered by oncologist-owned practices costs 3 to 14 percent less than hospital-owned oncology practices

Greatest dollar gaps seen in metastatic colorectal cancer, according to ASCO presentation

Chicago—June 3, 2014—Costs to treat and care for cancer patients can be 3 to 14 percent less depending on the type of cancer treated when care is coordinated by oncologist-owned practices than by hospital-owned practices, according to an analysis presented today at the American Society of Clinical Oncology’s annual meeting.

The retrospective analysis of pharmacy and medical claims was conducted by HealthCore, WellPoint’s outcomes research company. Funding for this open architecture analysis was provided by Genentech, a member of the Roche Group. The poster will be displayed from 8-11 a.m. Tuesday, June 3 at E354b with a discussion scheduled from 11:30 to 12:45 p.m. in E253.

“While the difference is significant, the cause is not completely clear,” said Dr. Jennifer Malin, WellPoint medical director for oncology. “Some of the differential can likely be attributed to higher facility fees paid to hospitals, but we can’t say that hospitals consistently use more expensive tests or therapies as an initial analysis suggests the opposite. More work needs to be done in this area to determine why.”

The observation period for the analysis was Jan 1, 2006 through Aug 31, 2012. An overall 8 percent gap in costs between the two practice types, covering five different types of cancer including breast cancer, colorectal cancer, lung cancer, and non-Hodgkin’s lymphoma and chronic lymphocytic leukemia for 18,740 commercially insured health plan members living in 14 states was shown. The costs include in-patient and outpatient visits, other outpatient services, emergency room visits and drug costs.

Cost differences between the two types of practices were statistically significant except in metastatic breast cancer. The following differences were found for early breast cancer, 8 percent; metastatic lung cancer, 7 percent; metastatic colorectal, 8 percent; and non-Hodgkin’s lymphoma and chronic lymphocytic leukemia, 14 percent.


Cancer care costs for metastatic colorectal care showed largest gap in actual costs with treatment prices averaging $105,093 when care was administered by oncologist-owned practices and $113,812 when care was administered by hospital oncologists.

“The differences in costs make an obvious impact in the overall economic burden to pay for oncology care,” said Maxine Fisher, HealthCore associate research director. “Among all the services, we saw the greatest cost gap between the two practice types in outpatient office visits and outpatient services which should be further explored.”

The study included overall cancer costs, such as cancer-related evaluations and interventions, cancer drugs and infusions, front-line treatment regimens, granulocyte-colony stimulating factor drugs use during the follow-up period and chemotherapy or hospitalizations prior to 30 days before death.

The analysis was conducted by HealthCore’s Maxine Fisher, Dr. Joseph Singer, Genentech’s Yeun Mi Yim, principal health economist and Dr. Art Small, director, oncology outcomes research, US Medical Affairs, WellPoint’s Dr. Jennifer Malin and Dr. Barbara McAneny from the New Mexico Oncology Hematology Cancer Center.

About HealthCore, Inc.
HealthCore, based in Wilmington, Del., is the clinical outcomes research subsidiary of WellPoint, Inc. HealthCore has a team of highly experienced researchers including physicians, biostatisticians, pharmacists, epidemiologists, health economists and other scientists who study the “real world” safety and effectiveness of drugs, medical devices and care management interventions. HealthCore offers insight on how to best use this data and communicates these findings to health care decision-makers to support evidence-based medicine, product development decisions, safety monitoring, coverage decisions, process improvement and overall cost-effective health care. For more information, go to

Media contact:

Lori McLaughlin, moc.tniopllew@2nilhgualcm.irol, 317.407.7403

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