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.