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DRGs Underpay for Stem Cell Therapy

DRGs Underpay for Stem Cell Therapy

SAN ANTONIO--Although the literature suggests that peripheral blood stem cell support for hematologic salvage after high-dose chemotherapy is somewhat less expensive than autologous bone marrow transplant (ABMT), the difference is nowhere near the $80,000 disparity found in diagnostic-related group (DRG)-based reimbursement, Philip Bierman, MD, said at a lymphoma symposium sponsored by the University of Texas M.D. Anderson Cancer Center.

The DRG allowance for a stem cell transplant for non-Hodgkin's lymphoma patients is $9,880, compared with more than $89,000 for ABMT, said Dr. Bierman, associate professor of medicine, University of Nebraska. But reports in the literature suggest a difference of only a few thousand dollars, he said.

Since DRG-based reimbursement is used primarily by Medicare, Medicaid, and Blue Cross/Blue Shield, only a small percentage of transplants are affected, he said, and he doesn't believe that physicians or hospitals have allowed the payment difference to influence clinical decision making. Furthermore, he said, the problem may be resolved next year when the government reviews the issue.

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