PURPOSE: The study objective was to provide population-based estimates of supportive care medication (SCM) use among Medicare beneficiaries with cancer and determine factors related to SCM receipt. METHODS: This retrospective cohort study of community-based Medicare beneficiaries used the Medicare Current Beneficiary Survey (1997–2007). Dependent variables comprised use and spending on SCMs for three medication classes: opioids, antidepressants/sedative/hypnotics (ASH), and antiemetics. Independent variables of interest were supplemental insurance coverage, cancer site, and treatment. Multivariate models determined factors affecting receipt of, and spending on, SCMs. We also compared SCM use and spending among beneficiaries with and without cancer in order to understand what portion of SCM use and spending could be attributed to cancer as opposed to other comorbid conditions. RESULTS: A total of 1,836 Medicare beneficiaries with cancer and 9,898 beneficiaries without cancer were eligible for the study. Beneficiaries with cancer were more likely to receive opioids, ASH, and antiemetics compared to non-cancer beneficiaries. Adjusted annual payments for antiemetics were on average $637 higher in with cancer versus without cancer (p<0.01), while ASH payments were $184 lower (p<0.01). Opioid spending was similar among cancer and non-cancer users. Relative to colon cancer, beneficiaries with prostate cancer were least likely to receive any of the three SCM classes. Receipt of antineoplastic treatment increased the probability of use of all three classes of SCMs. Insurance coverage did not influence the use of or spending on opioids or antiemetics, but was associated with both outcomes for ASH. The use of all three SCM classes was significantly lower during years before Part D implementation of the new Medicare Part D prescription drug benefit and was higher after implementation of Part D. CONCLUSION: This study provides population-based information on SCM use among Medicare beneficiaries with cancer. Cancer site and treatment modality were important predictors of SCM use.
PURPOSE: The study objective was to provide population-based estimates of supportive care medication (SCM) use among Medicare beneficiaries with cancer and determine factors related to SCM receipt. METHODS: This retrospective cohort study of community-based Medicare beneficiaries used the Medicare Current Beneficiary Survey (1997–2007). Dependent variables comprised use and spending on SCMs for three medication classes: opioids, antidepressants/sedative/hypnotics (ASH), and antiemetics. Independent variables of interest were supplemental insurance coverage, cancer site, and treatment. Multivariate models determined factors affecting receipt of, and spending on, SCMs. We also compared SCM use and spending among beneficiaries with and without cancer in order to understand what portion of SCM use and spending could be attributed to cancer as opposed to other comorbid conditions. RESULTS: A total of 1,836 Medicare beneficiaries with cancer and 9,898 beneficiaries without cancer were eligible for the study. Beneficiaries with cancer were more likely to receive opioids, ASH, and antiemetics compared to non-cancer beneficiaries. Adjusted annual payments for antiemetics were on average $637 higher in with cancer versus without cancer (p<0.01), while ASH payments were $184 lower (p<0.01). Opioid spending was similar among cancer and non-cancer users. Relative to colon cancer, beneficiaries with prostate cancer were least likely to receive any of the three SCM classes. Receipt of antineoplastic treatment increased the probability of use of all three classes of SCMs. Insurance coverage did not influence the use of or spending on opioids or antiemetics, but was associated with both outcomes for ASH. The use of all three SCM classes was significantly lower during years before Part D implementation of the new Medicare Part D prescription drug benefit and was higher after implementation of Part D. CONCLUSION: This study provides population-based information on SCM use among Medicare beneficiaries with cancer. Cancer site and treatment modality were important predictors of SCM use.
Authors: Kenneth M Langa; A Mark Fendrick; Michael E Chernew; Mohammed U Kabeto; Kerry L Paisley; James A Hayman Journal: Value Health Date: 2004 Mar-Apr Impact factor: 5.725
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Authors: Lincy S Lal; Lesley-Ann N Miller; Rebecca Arbuckle; Frank Hung; Chun Feng; Andrea Adamus; Michael J Fisch Journal: J Support Oncol Date: 2009 Nov-Dec
Authors: Lauren E Cipriano; Dorothy Romanus; Craig C Earle; Bridget A Neville; Elkan F Halpern; G Scott Gazelle; Pamela M McMahon Journal: Value Health Date: 2011-01 Impact factor: 5.725
Authors: Fredrick D Ashbury; Lisa Madlensky; Peter Raich; Mark Thompson; Geoff Whitney; Ken Hotz; Boris Kralj; William S Edell Journal: Support Care Cancer Date: 2003-03-06 Impact factor: 3.603
Authors: Gregory C Pope; John Kautter; Randall P Ellis; Arlene S Ash; John Z Ayanian; Lisa I Lezzoni; Melvin J Ingber; Jesse M Levy; John Robst Journal: Health Care Financ Rev Date: 2004
Authors: M Di Maio; F Perrone; C Gallo; R V Iaffaioli; L Manzione; F V Piantedosi; S Cigolari; A Illiano; S Barbera; S F Robbiati; E Piazza; G P Ianniello; L Frontini; E Veltri; F Castiglione; F Rosetti; E De Maio; P Maione; C Gridelli; Antonio Rossi; Emiddio Barletta; Maria Luisa Barzelloni; Giuseppe Signoriello; Domenico Bilancia; Angela Dinota; Gerardo Rosati; Domenico Germano; Alfredo Lamberti; Vittorio Pontillo; Luigi Brancacio; Carlo Crispino; Maria Esposito; Ciro Battiloro; Giovanni Tufano; Angela Cioffi; Vincenzo Guardasole; Valentina Angelini; Giovanna Guidetti; Santi Barbera; Francesco Renda; Francesco Romano; Antonio Volpintesta; Sergio Federico Robbiati; Mirella Sannicolò; Virginio Filipazzi; Gabriella Esani; Anna Gambaro; Sabrina Ferrario; Vincenza Tinessa; Maria Grazia Caprio; Sabrina Zonato; Mary Cabiddu; Alberto Raina; Enzo Veltri; Modesto D'Aprile; Giorgio Pistillucci; Gianfranco Porcile; Oliviero Ostellino; Orazio Vinante; Giuseppe Azzarello; Vittorio Gebbia; Nicola Borsellino; Antonio Testa; Giampietro Gasparini; Alessandra Morabito; Domenico Gattuso; Sante Romito; Francesco Carrozza; Sergio Fava; Anna Calcagno; Emanuela Grimi; Oscar Bertetto; Libero Ciuffreda; Giuseppe Parello; Luigi Maiorino; Antonio Santoro; Massimiliano Santoro; Giuseppe Failla; Rosa Anna Aiello; Alessandra Bearz; Roberto Sorio; Simona Scalone; Maurizia Clerici; Roberto Bollina; Paolo Belloni; Cosimo Sacco; Angela Sibau; Vincenzo Adamo; Giuseppe Altavilla; Antonino Scimone; Mario Spatafora; Vincenzo Bellia; Maria Raffealla Hopps; Silvio Monfardini; Adolfo Favaretto; Micaela Stefani; Giuliana Mara Corradini; Gianfranco Pavia; Giorgio Scagliotti; Silvia Novello; Giovanni Selvaggi; Maurizio Tonato; Samir Darwish; Giovanni Michetti; Maria Ori Belometti; Roberto Labianca; Antonello Quadri; Filippo De Marinis; Maria Rita Migliorino; Olga Martelli; Giuseppe Colucci; Dominico Galetta; Francesco Giotta; Luciano Isa; Paola Candido; Nestore Rossi; Antonio Calandriello; Francesco Ferraù; Emilia Malaponte; Sandro Barni; Marina Cazzaniga; Nicola Gebbia; Maria Rosaria Valerio; Mario Belli; Giuseppe Colantuoni; Matteo Antonio Capuano; Michele Angiolillo; Francesco Sollitto; Antonio Ardizzoia; Gino Luporini; Maria Cristina Locatelli; Franca Pari; Enrico Aitini; Tonino Pedicini; Antonio Febbraro; Cesira Zollo; Francesco Di Costanzo; Roberta Bartolucci; Silvia Gasperoni; Fernando Gaion; Giovanni Palazzolo; Enzo Galligioni; Orazio Caffo; Enrico Cortesi; Giuliana D'Auria; Carlo Curcio; Matteo Vasta; Cesare Bumma; Alfredo Celano; Sergio Bretti; Giuseppe Nettis; Annamaria Anselmo; Rodolfo Mattioli; Cecilia Nisticò; Annamaria Aschelter; Paola Foa Journal: Br J Cancer Date: 2003-09-15 Impact factor: 7.640