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Medicare Cuts May Have Spurred Drop in Prostate Cancer Treatment

FRIDAY, Dec. 3 (HealthDay News) -- Use of androgen suppression therapy for low-risk prostate cancer fell after doctors starting receiving lower Medicare payments for the treatment, but use of the treatment for patients with metastatic prostate cancer stayed steady, a new study shows.

The findings, published online Dec. 3 in the Journal of the National Cancer Institute, suggest the payment cuts may have reduced over-treatment of low-risk prostate cancer, the researchers said.

Between 1991 and 1999, the use of the therapy for prostate cancer increased more than threefold among patients with metastatic prostate cancer (cancer that has spread) and low-risk prostate cancer, even though the treatment has not been shown to improve survival in patients with low-risk disease.

When Medicare physician reimbursements for androgen therapy were reduced by 64 percent between 2004 and 2005, use of the therapy for men with low-risk prostate cancer fell by 40 percent while there was no statistically significant change among men with metastatic prostate cancer, the study found.

The researchers looked at factors other than Medicare payment cuts that could account for the findings, such as growing awareness of the therapy's side effects and increasing use of longer-acting treatments.

However, they concluded that the decline in use of androgen therapy for low-risk prostate cancer patients "likely represents a real effect of reimbursement change and not physician awareness of clinical evidence," wrote Dr. Sean P. Elliott, of the University of Minnesota, and colleagues in a news release from the journal.

More information

The American Urological Association has more about hormone therapy for prostate cancer.

-- Robert Preidt

SOURCE: Journal of the National Cancer Institute, news release, Dec. 3, 2010

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