segment).
(2) Corporate costs relate primarily to general and administrative
expenses in support of our network.
(3) Impairment and restructuring charges, other expense and the loss on
debt extinguishment are excluded from Adjusted EBITDA.
(4) Not meaningful.
Medical Oncology Services
In the first quarter of 2008, medical oncology services revenue increased $30.9 million, or 5.9 percent, from the first quarter of 2007. The revenue increase reflects an increase in daily visits and growth in our network of affiliated medical oncologists. Partially offsetting the increase in daily visits was a reduction in the utilization of supportive care drugs. Compared to the first quarter of 2007, Adjusted EBITDA decreased $6.2 million which relates primarily to a reduction in earnings from the use of supportive care drugs by affiliated medical oncologists, along with a $1.7 million decrease attributable to our program to promote continued support of pharmaceutical services initiatives.
Compared to the fourth quarter of 2007, medical oncology services revenue increased $23.4 million, or 4.4 percent which reflects new affiliations during the first quarter of 2008. Adjusted EBITDA decreased $0.7 million from the fourth quarter of 2007 as reduced earnings from supportive care drugs and management fee reductions more than offset earnings from recent affiliations.
Cancer Center Services
Cancer center services revenue in the first quarter of 2008 was $90.1
million, an increase of $5.8 million, or 6.9 percent, and Adjusted EBITDA
was $31.1 million, an increase of $1.6 million, or 5.4 percent, over the
first quarter of 2007. These increases reflect increasing diagnostic scans
over the same period in the prior year. Additionally, radiation volumes
continue to shift toward advanced targeted radiation therapies, such as
image guided radiation therapy
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