Jj. Lokich et al., COMPARISON OF COSTS FOR INFUSION VERSUS BOLUS CHEMOTHERAPY ADMINISTRATION .2. USE OF CHARGES VERSUS REIMBURSEMENT FOR COST BASIS, Cancer, 78(2), 1996, pp. 300-303
BACKGROUND. The cost of infusion versus bolus administration of chemot
herapy has been a point of controversy as has been the method of quant
itating the cost. The present study analyzes the reimbursement for che
motherapy administration by infusion compared with bolus delivery base
d on reimbursement and relates this to cost based on projected charges
and actual charges in a private practice setting. METHODS, Actual rei
mbursement records were retrieved for selected patients receiving infu
sion or bolus administration of specific chemotherapy regimens for thr
ee tumors: colon carcinoma, breast carcinoma, and lymphoma. All servic
es were included except for radiology and hospitalization. Medicare re
imbursement represented 90% of the treatment cycles analyzed. RESULTS,
Actual reimbursement per month for each infusion regimen was as follo
ws: colon carcinoma, $528 (5-fluorouracil [5-FU]); breast carcinoma, $
621 (doxorubicin and cyclophosphamide [AC]) and $685 (cyclophosphamide
, methotrexate, and fluorouracil [CMF]); and lymphoma, $603 (cyclophos
phamide, doxorubicin, vincristine, and prednisone [CHOP]). Actual reim
bursement per month for a bolus regimen was colon carcinoma, $393 (5-F
U + leucovorin); breast carcinoma, $991 (AC) or $453 (CMF); and lympho
ma, $749 (CHOP). Actual reimbursement represents 21-36% of actual char
ges. Projected charges based on the model system are generally less th
an the actual charges. CONCLUSIONS. The cost of chemotherapy as define
d by reimbursement are substantially less than actual charges and are
also less than projected costs based on charges. Data comparing bolus
versus infusion reimbursement costs for colon carcinoma, breast carcin
oma, and lymphoma indicate that differences between reimbursement for
bolus and infusion administration are not substantial. (C) 1996 Americ
an Cancer Society.