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Oncologists Still Avoid Discussing Cost of Care

(Medscape Medical News) Aug 7, 2017 - Many professional medical organizations that provide guidance for cancer care now advocate a discussion of cost, including the American Society of Clinical Oncology (ASCO), which has urged physicians to do so since 2009. Few clinicians do, however, according to several sets of data.

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Thomas Marsland, MD (Posted: August 10, 2017)

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So I usually do not even know the exact cost of the drugs. I believe for me and many of us this is a carry over from the days that chemo was a revenue generator for the practice and I did not want to be biased by potential income and wanted to base my treatment recommendations based on the effectiveness and toxicity of the drugs. With that said I am aware of the general expense of the drugs and will often tell patients that the treatment is "expensive." Indeed we do make treatment choice today based on cost, especially in relation to whether the treatment may fall under the medical or pharmacy benefit package. We do have financial counsilors in our practice who can and do have the expertise to make patients aware of the cost of therapies. It really is unrealistic to expect the doc to spend a lot to time talking about drug cost and insurance benefits, things about which we really know every little when our time is much better spent discussing the patient's disease, treatments, and outcomes. The recent NCCN review of patient concept of value confirms that what they really want is time with the physician to discuss their outcomes. Clearly cost is a key piece of the value proposition but it is not the only one and I believe patients are better served discussion cost and coverage with our financial councilors who are better trained to do this than me.

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